Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00307100 | NJ |
NPI | 1003123720 |
---|---|
Provider Name | Emily Elizabeth Simmons |
First Address | Westfield, NJ 07090 |
Second Address | Westfield, NJ 07090-2520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2010 |
Last Update Date | 01/02/2016 |