Provider Demographics
NPI:1245718261
Name:SIMMONS, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
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 1:1250 S BUCKLEY RD STE I125
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4180
Mailing Address - Country:US
Mailing Address - Phone:720-491-1424
Mailing Address - Fax:720-491-1424
Practice Address - Street 1:10651 E BETHANY DR STE 130
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2679
Practice Address - Country:US
Practice Address - Phone:720-491-1424
Practice Address - Fax:720-491-1424
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician