TREVINO C SIMMONS FNP
NPI 1346797065
Nurse Practitioner - Family in Ellenwood, GA
Active since September 10, 2016
About Trevino C Simmons Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TREVINO C SIMMONS FNP (NPI 1346797065) is an individual family provider in Ellenwood, Georgia, licensed in Georgia (RN192990) and active in the NPI registry since September 2016.
NPPES Registry Identity
NPI1346797065
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameTREVINO C SIMMONSCredential: FNP
Location Address256 ESSEX PLEllenwood, GA 30294-4106
Mailing Address256 Essex PlEllenwood, GA 30294-4106 · (770) 380-9756
Phone(770) 380-9756
Sole ProprietorYes
Enumeration DateSeptember 10, 2016
✔ NPI 1346797065 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN192990
256 ESSEX PL, Ellenwood, GA 30294
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1346797065, enumerated as an "individual" on September 10, 2016.
The provider is located at 256 ESSEX PL ELLENWOOD, GA 30294 and the phone number is (770) 380-9756.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
