Provider Demographics
NPI:1558555763
Name:SIMMEN, FLORA JEAN (OTR)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:JEAN
Last Name:SIMMEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 WALNUT BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-2814
Mailing Address - Country:US
Mailing Address - Phone:440-964-6971
Mailing Address - Fax:
Practice Address - Street 1:4533 PARK AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6930
Practice Address - Country:US
Practice Address - Phone:440-992-9441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004622314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility