Provider Demographics
NPI:1851674568
Name:SIMMONS, CARRIE CLARK (FNP-C, MSN, BSN, RN)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:CLARK
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:FNP-C, MSN, BSN, RN
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:NICOLE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C, MSN, BSN, RN
Mailing Address - Street 1:333 COMMERCE ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1826
Mailing Address - Country:US
Mailing Address - Phone:615-913-5086
Mailing Address - Fax:888-494-2588
Practice Address - Street 1:2425 WEST LOOP S STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-4208
Practice Address - Country:US
Practice Address - Phone:832-786-4970
Practice Address - Fax:855-722-0157
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX688429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX448135ZMSYMedicare PIN