Provider Demographics
NPI:1841013380
Name:SIMMERMAN, ERIN (MA, LAT, ATC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SIMMERMAN
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S C STAR BLVD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1252
Mailing Address - Country:US
Mailing Address - Phone:402-587-2422
Mailing Address - Fax:
Practice Address - Street 1:207 S C STAR BLVD UNIT 4
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-1252
Practice Address - Country:US
Practice Address - Phone:402-587-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer