Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 24393 | MN |
N | 208000000X | Pediatrician | 24393 | MN |
NPI | 1003888660 |
---|---|
Provider Name | Patricia S Simmons |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 06/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
370000462 | MEDICARE, RAILROAD (01) | MN |
680327000 | (05) | MN |
E95571 | (02) |