Provider Demographics
NPI:1114391794
Name:SIMMONS, JENNIFER LEIGH-ANNE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH-ANNE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4501 NELSON RD UNIT 2203
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-9433
Mailing Address - Country:US
Mailing Address - Phone:720-340-4865
Mailing Address - Fax:720-340-4865
Practice Address - Street 1:4501 NELSON RD UNIT 2203
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9433
Practice Address - Country:US
Practice Address - Phone:720-340-4865
Practice Address - Fax:720-340-4865
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1628627251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health