Provider Demographics
NPI:1558515148
Name:SIMMONS, MAE ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:MAE
Middle Name:ELIZABETH
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHINA
Mailing Address - State:ME
Mailing Address - Zip Code:04358-5006
Mailing Address - Country:US
Mailing Address - Phone:207-445-5695
Mailing Address - Fax:
Practice Address - Street 1:5 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH CHINA
Practice Address - State:ME
Practice Address - Zip Code:04358-5006
Practice Address - Country:US
Practice Address - Phone:207-445-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-09
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER028727163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health