Provider Demographics
NPI:1689066458
Name:SIMMS, CHRISTINE M (MSN, APRN, BC OR CNS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:SIMMS
Suffix:
Gender:F
Credentials:MSN, APRN, BC OR CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E. FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2936
Mailing Address - Country:US
Mailing Address - Phone:610-892-3802
Mailing Address - Fax:610-892-2774
Practice Address - Street 1:36 E. FRONT ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2936
Practice Address - Country:US
Practice Address - Phone:610-892-3802
Practice Address - Fax:610-892-2774
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN108603L163W00000X
PA0183860CCNS364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse