Provider Demographics
NPI:1043595077
Name:SIMMS, LAUREN DANIELLE (MNT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:DANIELLE
Last Name:SIMMS
Suffix:
Gender:F
Credentials:MNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 S QUEBEC ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4671
Mailing Address - Country:US
Mailing Address - Phone:303-999-1063
Mailing Address - Fax:303-220-9134
Practice Address - Street 1:6500 S QUEBEC ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-4671
Practice Address - Country:US
Practice Address - Phone:303-999-1063
Practice Address - Fax:303-220-9134
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist