Provider Demographics
NPI:1306583067
Name:SIMM, AMBER D (APRN-FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:D
Last Name:SIMM
Suffix:
Gender:F
Credentials:APRN-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4627 WESTWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1914
Mailing Address - Country:US
Mailing Address - Phone:740-610-3660
Mailing Address - Fax:
Practice Address - Street 1:4810 EVERHARD RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2413
Practice Address - Country:US
Practice Address - Phone:234-360-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-15
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP0030851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily