Provider Demographics
NPI:1568829646
Name:SIMMONS, RHONDA JAN (RN-BC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JAN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7614
Mailing Address - Country:US
Mailing Address - Phone:405-317-3901
Mailing Address - Fax:
Practice Address - Street 1:1109 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7614
Practice Address - Country:US
Practice Address - Phone:405-317-3901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0056807163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management