Provider Demographics
NPI:1790194488
Name:SIMMONS, BETH ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:SIBBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 E 23RD ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4440
Mailing Address - Country:US
Mailing Address - Phone:646-650-5337
Mailing Address - Fax:
Practice Address - Street 1:30 E 23RD ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4440
Practice Address - Country:US
Practice Address - Phone:646-650-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60302585163W00000X
NY844716163W00000X
NY350538363LF0000X
WAAP60490367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse