Provider Demographics
NPI:1649514514
Name:SIMMONS, JENA L (CRNP)
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:L
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:L
Other - Last Name:KRAGNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:106 BETHANY DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2910
Mailing Address - Country:US
Mailing Address - Phone:724-941-5588
Mailing Address - Fax:724-941-1458
Practice Address - Street 1:455 VALLEYBROOK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3367
Practice Address - Country:US
Practice Address - Phone:724-941-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily