Provider Demographics
NPI:1376813881
Name:SIMMONS, CATHERINE (NNP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 ERWIN RD STE 504
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3826
Mailing Address - Country:US
Mailing Address - Phone:919-970-0774
Mailing Address - Fax:919-681-6065
Practice Address - Street 1:5524 ERWIN ROAD HOSPITAL N BOX 100500
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-970-0774
Practice Address - Fax:919-681-6065
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-31
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC125109363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care