Provider Demographics
NPI:1720021595
Name:SIMONDS, LAUREA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAUREA
Middle Name:M
Last Name:SIMONDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LAUREA
Other - Middle Name:M
Other - Last Name:WHITON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:113 NEW ROCHESTER ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820
Mailing Address - Country:US
Mailing Address - Phone:603-742-6555
Mailing Address - Fax:603-742-3256
Practice Address - Street 1:113 NEW ROCHESTER ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820
Practice Address - Country:US
Practice Address - Phone:603-742-6555
Practice Address - Fax:603-742-3256
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0493P363A00000X
NH0493363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30332543Medicaid
NHWHAP2056Medicare ID - Type UnspecifiedMEDICARE NUMBER
NH30332543Medicaid