Healthcare Provider Details

I. General information

NPI: 1366670085
Provider Name (Legal Business Name): EUNICE E SIMMONS LIC. AC. RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 N PEARL ST
BROCKTON MA
02301-1708
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE STE 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 508-508-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number212677
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number2258485
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: