MEDICARE: MS. ADRIENNE SIMMONS FAMILY NURSE PRACTIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN317916L	PA

General Provider Information

NPI Number	:	1558346718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADRIENNE SIMMONS FAMILY NURSE PRACTIT

Provider Business Mailing Address
First Line	:	PSC 475 BOX 1718
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96350
Country	:	US
Telephone Number	:	215-965-1522
Fax Number	:

Provider Business Practice Location Address
First Line	:	USNH YOKOSUKA JAPAN
Second Line	:	PSC 475 BOX 1
City	:	FPO
State	:	AP
Zip	:	96350
Country	:	US
Telephone Number	:	01181468165564
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2005
Last Update Date	:	07/21/2022

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