Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024182378 | VA |
NPI | 1013682822 |
---|---|
Provider Name | Ashley Danielle Simmons |
First Address | Danville, VA 24540-4556 |
Second Address | Greensboro, NC 27477-4556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 10/02/2022 |