Provider Demographics
NPI:1871124107
Name:SIMMONS, KRISTAL LYN (FNP)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:LYN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KRISTAL
Other - Middle Name:LYN
Other - Last Name:SETTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 N 17TH PL
Mailing Address - Street 2:
Mailing Address - City:SLATON
Mailing Address - State:TX
Mailing Address - Zip Code:79364-3100
Mailing Address - Country:US
Mailing Address - Phone:806-746-7519
Mailing Address - Fax:
Practice Address - Street 1:1307 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79403-5329
Practice Address - Country:US
Practice Address - Phone:806-749-3800
Practice Address - Fax:806-749-3802
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1444805363LF0000X
TXAP144805363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily