Provider Demographics
NPI:1275751315
Name:SIMMONS, DEJA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:DEJA
Middle Name:MARIE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEJA
Other - Middle Name:MARIE
Other - Last Name:TROJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8007 E LEHIGH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1534
Mailing Address - Country:US
Mailing Address - Phone:303-808-6282
Mailing Address - Fax:720-519-1471
Practice Address - Street 1:4950 S YOSEMITE ST
Practice Address - Street 2:F2-242
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1349
Practice Address - Country:US
Practice Address - Phone:303-808-6282
Practice Address - Fax:720-519-1471
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2076363AS0400X
FLPA 9104225363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical