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NPI Code Detail

MEDICARE: MRS. MAE ELIZABETH SIMMONS RN

MEDICARE: MRS. MAE ELIZABETH SIMMONS RN
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
1163WH0200XHome Health Registered NurseR028727ME

General Provider Information

NPI Number : 1558515148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MAE ELIZABETH SIMMONS RN
Provider Business Mailing Address
First Line : 5 E WASHINGTON BLVD
Second Line :
City : SOUTH CHINA
State : ME
Zip : 04358-5006
Country : US
Telephone Number : 207-445-5695
Fax Number :
Provider Business Practice Location Address
First Line : 5 E WASHINGTON BLVD
Second Line :
City : SOUTH CHINA
State : ME
Zip : 04358-5006
Country : US
Telephone Number : 207-445-5695
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2008
Last Update Date : 11/09/2008

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