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Wanda Simmons

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4974 Higbee Ave NW Ste 103, Canton, OH 44718-2562

PECOS Enrollment

Based on the most recent information from CMS, provider Wanda Simmons is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1720539018
Provider Type
Individual
Full Name
Simmons, Wanda
Credential
CNP

Gender
Female
Sole Proprietor
No
Enumeration Date
10/20/2016
Last Updated
6/17/2024

Contact Information

Practice Location

4974 Higbee Ave NW Ste 103, Canton, OH 44718-2562

(330) 933-4691

(855) 873-7557

Mailing Location

1032 E Brandon Blvd Ste 4567, Brandon, FL 33511-5509

(201) 474-5844

(807) 804-1324

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License CNP019767 Ohio

Wanda Simmons

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Stearns, David Allen

Gordon, Marian Kathleen

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Stark Family Health Center

Berg, Melissa

Mcavinew, Benjamin

Ham, Sirilak

Laughlin, Ashley

Dundon, Sybil L

Johnson, Heather