Provider Demographics
NPI:1114147659
Name:SIMMONS-ALLING, SUSAN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:SIMMONS-ALLING
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 1:1204 POND RD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-1963
Mailing Address - Country:US
Mailing Address - Phone:732-859-4152
Mailing Address - Fax:
Practice Address - Street 1:21 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1801
Practice Address - Country:US
Practice Address - Phone:732-859-4152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC07965800364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult