Provider Demographics
NPI:1063979904
Name:SIMMONS, ALLISON CHRISTINE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:CHRISTINE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-2750
Mailing Address - Country:US
Mailing Address - Phone:508-264-7417
Mailing Address - Fax:
Practice Address - Street 1:24 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-2750
Practice Address - Country:US
Practice Address - Phone:508-264-7417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program