MEDICARE: PETA-GAY NATALIE SIMMONDS-CARROO CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	376J00000X	Homemaker
2	376K00000X	Nurse's Aide
3	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1649139106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETA-GAY NATALIE SIMMONDS-CARROO CNA

Provider Business Mailing Address
First Line	:	21 WOOD TER
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-2432
Country	:	US
Telephone Number	:	929-944-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 WOOD TER
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-2432
Country	:	US
Telephone Number	:	929-944-5908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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