Provider Demographics
NPI:1497903884
Name:SIMMONS, KECIA RENEE (GNP)
Entity Type:Individual
Prefix:MS
First Name:KECIA
Middle Name:RENEE
Last Name:SIMMONS
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Gender:F
Credentials:GNP
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Mailing Address - Street 1:2203 NEUSE BOULEVARD
Mailing Address - Street 2:COASTAL SURGICAL SPECIALISTS, PA
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4311
Mailing Address - Country:US
Mailing Address - Phone:252-638-8118
Mailing Address - Fax:252-638-5192
Practice Address - Street 1:2203 NEUSE BOULEVARD
Practice Address - Street 2:COASTAL SURGICAL SPECIALISTS, PA
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4311
Practice Address - Country:US
Practice Address - Phone:252-638-8118
Practice Address - Fax:252-638-5192
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
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Provider Licenses
StateLicense IDTaxonomies
NC38894208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)