Provider Demographics
NPI:1386080752
Name:SIMMONS, MOLLY ANNETTE (APN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:ANNETTE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:APN, FNP-C
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ANNETTE
Other - Last Name:HUTCHISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:118 TRADEPARK DR STE B
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3427
Practice Address - Country:US
Practice Address - Phone:606-416-5225
Practice Address - Fax:606-416-5386
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily