Provider Demographics
NPI:1881567519
Name:SIMMONS, HEATHER (CNA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 CAMILLA ST SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-3149
Mailing Address - Country:US
Mailing Address - Phone:470-923-7107
Mailing Address - Fax:
Practice Address - Street 1:987 CAMILLA ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-3149
Practice Address - Country:US
Practice Address - Phone:470-923-7107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030079318376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty