Provider Demographics
NPI:1770218877
Name:SIMMS, STENSON REAGAN (NP)
Entity Type:Individual
Prefix:
First Name:STENSON
Middle Name:REAGAN
Last Name:SIMMS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MCFARLAND ST STE D
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3992
Mailing Address - Country:US
Mailing Address - Phone:423-839-2525
Mailing Address - Fax:423-839-2424
Practice Address - Street 1:500 MCFARLAND ST STE D
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3992
Practice Address - Country:US
Practice Address - Phone:423-839-2525
Practice Address - Fax:423-839-2424
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32087363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner