Provider Demographics
NPI:1013645431
Name:SIMMONS, ALICIA R (APRN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:R
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3683 N COUNTY ROAD 650 E
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:IN
Mailing Address - Zip Code:47452-9653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:534 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1296
Practice Address - Country:US
Practice Address - Phone:270-422-5000
Practice Address - Fax:270-422-5052
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28158742A163WA0400X
KY4044040363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)