Provider Demographics
NPI:1780991521
Name:SIMMONS, JOANNA (PHARMD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 ERWIN RD
Mailing Address - Street 2:APT 2440
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3843
Mailing Address - Country:US
Mailing Address - Phone:919-794-1358
Mailing Address - Fax:
Practice Address - Street 1:2616 ERWIN RD
Practice Address - Street 2:APT 2440
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3843
Practice Address - Country:US
Practice Address - Phone:919-794-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist