Provider Demographics
NPI:1235859679
Name:SIMMONS, PRECIOUS (RN)
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PATROON CREEK BLVD APT 3351
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-5035
Mailing Address - Country:US
Mailing Address - Phone:914-920-1188
Mailing Address - Fax:
Practice Address - Street 1:255 PATROON CREEK BLVD APT 3351
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-5035
Practice Address - Country:US
Practice Address - Phone:914-920-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY89506201163WH0200X
NY334336164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse