Provider Demographics
NPI:1356936751
Name:SIMMONS, CALEB ANDREW (MSN, APN, PMHNP)
Entity type:Individual
Prefix:MR
First Name:CALEB
Middle Name:ANDREW
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:MSN, APN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 N COUNTY ROAD 400 E
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-8251
Mailing Address - Country:US
Mailing Address - Phone:765-652-2265
Mailing Address - Fax:
Practice Address - Street 1:1702 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1033
Practice Address - Country:US
Practice Address - Phone:765-362-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28236157A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health