Provider Demographics
NPI:1417155722
Name:SIMMONS-STUBER, MARGIE (RN, BSN, NMD)
Entity Type:Individual
Prefix:DR
First Name:MARGIE
Middle Name:
Last Name:SIMMONS-STUBER
Suffix:
Gender:F
Credentials:RN, BSN, NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 E DOWNING CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6449
Mailing Address - Country:US
Mailing Address - Phone:602-809-4810
Mailing Address - Fax:
Practice Address - Street 1:4840 E DOWNING CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-6449
Practice Address - Country:US
Practice Address - Phone:602-809-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00-583175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty