Provider Demographics
NPI:1811408818
Name:SIMMONS, REBEKAH WASHINGTON (APRN)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:WASHINGTON
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5782 ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905-1950
Mailing Address - Country:US
Mailing Address - Phone:706-949-2434
Mailing Address - Fax:
Practice Address - Street 1:1810 STADIUM DR STE 240
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3179
Practice Address - Country:US
Practice Address - Phone:334-291-8303
Practice Address - Fax:334-291-8325
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK126470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily