Provider Demographics
NPI:1609641828
Name:SIMMONS, ARUNDA FAYE
Entity Type:Individual
Prefix:
First Name:ARUNDA
Middle Name:FAYE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 ROE AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53404-3425
Mailing Address - Country:US
Mailing Address - Phone:262-221-3701
Mailing Address - Fax:
Practice Address - Street 1:1837 ROE AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53404-3425
Practice Address - Country:US
Practice Address - Phone:262-221-3701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide