Provider Demographics
NPI:1942557947
Name:SIMMONS, BRANDY NATE'
Entity Type:Individual
Prefix:MISS
First Name:BRANDY
Middle Name:NATE'
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 WEST WARM SPRINGS ROAD
Mailing Address - Street 2:APT 4221
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-371-2026
Mailing Address - Fax:
Practice Address - Street 1:2101 W WARM SPRINGS RD
Practice Address - Street 2:APT 4221
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-5516
Practice Address - Country:US
Practice Address - Phone:702-371-2026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health