Provider Demographics
NPI:1679799720
Name:SIMMONS, TAMARA SAMONE (LPN)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:SAMONE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E HORTTER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2045
Mailing Address - Country:US
Mailing Address - Phone:215-740-6149
Mailing Address - Fax:
Practice Address - Street 1:GENERAL HEALTHCARE RESOURCES, INC.
Practice Address - Street 2:2250 HICKORY ROAD, SUITE 240
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:800-879-4471
Practice Address - Fax:610-834-7525
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN266866164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse