Provider Demographics
NPI:1699099812
Name:SIMMONS, CHERYLL N (DNP, FNP-BC, MPH)
Entity type:Individual
Prefix:
First Name:CHERYLL
Middle Name:N
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:DNP, FNP-BC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:ND
Mailing Address - Zip Code:58068-4004
Mailing Address - Country:US
Mailing Address - Phone:701-561-8201
Mailing Address - Fax:
Practice Address - Street 1:9629 BIA ROAD 21
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-3841
Practice Address - Country:US
Practice Address - Phone:701-561-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR41324363LF0000X
FL3368492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily