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General NPI Number Information
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NPI Number | 1164822813
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Entity Type | Individual
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Provider Name | JOHN SIMMONS FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/31/2014
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 520 NM HIGHWAY 564
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City | GALLUP
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State | NM
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Zip | 87301-4873
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Country | US
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Telephone | 505-542-0090
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Fax | 520-542-0155
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Provider Business Mailing Address
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Address Line | 9192 W UNION HILLS DR
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City | PEORIA
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State | AZ
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Zip | 85382-8208
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Country | US
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Telephone | 602-374-4101
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Fax | 602-441-0522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP126129
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP-02772
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License Number State | NM
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