Provider Demographics
NPI:1528384252
Name:SIMMONS, KATHRYN A (FNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 REGIONAL PLZ
Mailing Address - Street 2:SUITE 1675
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5250
Mailing Address - Country:US
Mailing Address - Phone:325-795-2100
Mailing Address - Fax:325-795-2113
Practice Address - Street 1:6200 REGIONAL PLZ
Practice Address - Street 2:SUITE 1675
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5250
Practice Address - Country:US
Practice Address - Phone:325-795-2100
Practice Address - Fax:325-795-2113
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX706448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2010002018OtherBOARD CERTIFICATION