Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN2261201 | MA |
NPI | 1023421880 |
---|---|
Provider Name | Daniel Richard Simoneau |
First Address | Fall River, MA 02723-1026 |
Second Address | Fall River, MA 02723-1026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 09/06/2014 |