Provider Demographics
NPI:1023006582
Name:SIMMS, ALAN D (CRNA BS)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:D
Last Name:SIMMS
Suffix:
Gender:M
Credentials:CRNA BS
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:16431 SUNDANCE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-7021
Mailing Address - Country:US
Mailing Address - Phone:636-394-1893
Mailing Address - Fax:
Practice Address - Street 1:10010 KENNERLY RD
Practice Address - Street 2:ST ANTHONYS HOSPITAL
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1659
Practice Address - Country:US
Practice Address - Phone:314-895-3828
Practice Address - Fax:314-985-3827
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO035653163W00000X
MO069345367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL48762498C001Medicaid
MO04606175Medicare ID - Type Unspecified