Provider Demographics
NPI:1871787655
Name:SIMMS, KENDELL LOUISE (AUD)
Entity type:Individual
Prefix:MRS
First Name:KENDELL
Middle Name:LOUISE
Last Name:SIMMS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:KENDELL
Other - Middle Name:LOUISE
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-498-6650
Mailing Address - Fax:402-452-5015
Practice Address - Street 1:555 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2136
Practice Address - Country:US
Practice Address - Phone:402-498-6650
Practice Address - Fax:402-452-5015
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist