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General NPI Number Information
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NPI Number | 1568679181
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Entity Type | Individual
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Provider Name | JANET LYNN SIMMONS RN
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 329 N BERGIN LN
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City | BLOOMFIELD
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State | NM
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Zip | 87413-6729
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Country | US
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Telephone | 505-632-4356
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Fax | 505-634-3872
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Provider Business Mailing Address
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Address Line | 5416 VILLA VIEW DR
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City | FARMINGTON
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State | NM
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Zip | 87402-8269
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Country | US
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Telephone | 505-632-4356
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Fax | 505-634-3872
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | R30172
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License Number State | NM
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