Provider Demographics
NPI:1760027528
Name:SIMMS, NOELLE HONOREE (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:HONOREE
Last Name:SIMMS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:HONOREE
Other - Last Name:BREIDENBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:MAIL DROP 4S-205
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127
Mailing Address - Country:US
Mailing Address - Phone:858-605-7171
Mailing Address - Fax:
Practice Address - Street 1:9898 GENESEE AVE FL 3
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1205
Practice Address - Country:US
Practice Address - Phone:858-824-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012170363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner