Provider Demographics
NPI:1558346718
Name:SIMMONS, ADRIENNE (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 475 BOX 1718
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96350
Mailing Address - Country:US
Mailing Address - Phone:215-965-1522
Mailing Address - Fax:
Practice Address - Street 1:USNH YOKOSUKA JAPAN
Practice Address - Street 2:PSC 475 BOX 1
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96350
Practice Address - Country:US
Practice Address - Phone:0118146-816-5564
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN317916L363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily