Provider Demographics
NPI:1528572740
Name:SIMMONS, VALENCIA (LVN)
Entity Type:Individual
Prefix:MS
First Name:VALENCIA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5207 VILLAGE GLN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3800
Mailing Address - Country:US
Mailing Address - Phone:773-318-6733
Mailing Address - Fax:
Practice Address - Street 1:5207 VILLAGE GLN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3800
Practice Address - Country:US
Practice Address - Phone:773-318-6733
Practice Address - Fax:773-318-6733
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329637164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse