Provider Demographics
NPI:1982205746
Name:SIMMONS, DEBORA JOYCE (RN CCNS FAAN)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:JOYCE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN CCNS FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10915 CORY ST
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-5505
Mailing Address - Country:US
Mailing Address - Phone:281-610-7028
Mailing Address - Fax:
Practice Address - Street 1:10915 CORY ST
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-5505
Practice Address - Country:US
Practice Address - Phone:281-610-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110212163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine