Provider Demographics
NPI:1780097899
Name:SIMMONS, THOMAISNA ANGELA
Entity type:Individual
Prefix:
First Name:THOMAISNA
Middle Name:ANGELA
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 1:755 CONVERSE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3634
Mailing Address - Country:US
Mailing Address - Phone:513-825-1192
Mailing Address - Fax:513-825-1192
Practice Address - Street 1:755 CONVERSE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3634
Practice Address - Country:US
Practice Address - Phone:513-544-3572
Practice Address - Fax:513-825-1192
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant