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NPI Code Detail

MEDICARE: LAQUANDA SIMMONS

MEDICARE:   LAQUANDA  SIMMONS
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
1164W00000XLicensed Practical Nurse319222-1NY

General Provider Information

NPI Number : 1942698030
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAQUANDA SIMMONS
Provider Business Mailing Address
First Line : 388 SCIO ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2632
Country : US
Telephone Number : 585-957-4913
Fax Number :
Provider Business Practice Location Address
First Line : 388 SCIO ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2632
Country : US
Telephone Number : 585-957-4913
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2014
Last Update Date : 12/26/2014

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Directions to “ LAQUANDA SIMMONS ” Practice Location

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