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General NPI Number Information
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NPI Number | 1225559099
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Entity Type | Individual
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Provider Name | SHAQUILLA SIMMONS RN
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Gender | Female
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 15 CENTRE SQ
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City | EASTON
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State | PA
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Zip | 18042-3607
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Country | US
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Telephone | 856-525-9186
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 75
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City | BRIDGETON
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State | NJ
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Zip | 08302-0060
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Country | US
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Telephone | 856-558-5627
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP034167
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR19061900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN689236
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 407981
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License Number State | NY
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