Provider Demographics
NPI:1700360328
Name:SIMMONS, CIJIANA RENE (NP)
Entity Type:Individual
Prefix:
First Name:CIJIANA
Middle Name:RENE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CIJIANA
Other - Middle Name:
Other - Last Name:DUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:150 E BEASLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-7382
Mailing Address - Country:US
Mailing Address - Phone:509-948-2168
Mailing Address - Fax:
Practice Address - Street 1:560 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-2006
Practice Address - Country:US
Practice Address - Phone:931-796-7658
Practice Address - Fax:931-796-7697
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60883167363LF0000X
TN27243363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily