Provider Demographics
NPI:1841414810
Name:SIMMONS, LINDA ANN (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:HENTHORN-SIMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:40522 N COPPER BASIN TRL
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1838
Mailing Address - Country:US
Mailing Address - Phone:623-551-1923
Mailing Address - Fax:
Practice Address - Street 1:42901 N 45TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85087-7002
Practice Address - Country:US
Practice Address - Phone:623-376-5210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool