Provider Demographics
NPI:1518565100
Name:SIMMONS, MERLE PERRY
Entity Type:Individual
Prefix:MR
First Name:MERLE
Middle Name:PERRY
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44090
Mailing Address - Country:US
Mailing Address - Phone:440-371-3845
Mailing Address - Fax:
Practice Address - Street 1:345 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:OH
Practice Address - Zip Code:44090
Practice Address - Country:US
Practice Address - Phone:440-371-3845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker