Provider Demographics
NPI:1942981543
Name:SIMIYU, RHODAH NEKESA
Entity Type:Individual
Prefix:
First Name:RHODAH
Middle Name:NEKESA
Last Name:SIMIYU
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 1:1024 E BROAD ST STE 207
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7702
Mailing Address - Country:US
Mailing Address - Phone:682-518-3333
Mailing Address - Fax:682-518-3323
Practice Address - Street 1:1024 E BROAD ST STE 207
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7702
Practice Address - Country:US
Practice Address - Phone:682-518-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1127285363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health