Provider Demographics
NPI:1245096585
Name:SIMMONS, JAMIRAH A (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:JAMIRAH
Middle Name:A
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 COMMONWEALTH PL STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4530
Mailing Address - Country:US
Mailing Address - Phone:757-737-5163
Mailing Address - Fax:767-937-2763
Practice Address - Street 1:900 COMMONWEALTH PL STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4530
Practice Address - Country:US
Practice Address - Phone:757-737-5163
Practice Address - Fax:767-937-2763
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAM4F3C2W3247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician