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Organization
SHARONELLE SIMMONS, M.D
Active
Organization
SHARONELLE SIMMONS, M.D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARONELLE SIMMONS M.D. (MEMBER/MEDICAL DIRECTOR)
(480) 949-1182
Entity
Organization
Contact information
Practice address
6200 S MCCLINTOCK DR STE 104, TEMPE, AZ 85283-3268
(480) 388-3666
(480) 388-3667
Mailing address
6200 S MCCLINTOCK DR STE 104, TEMPE, AZ 85283-3268
(480) 388-3666
(480) 388-3667
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13628
AZ
363LW0102X
Women's Health Nurse Practitioner
—
NULL
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z7430
HEALTHNET
—
01
—
2569417
AETNA
AZ
01
—
AZ0071880
BC/BS OF AZ.
AZ
Enumeration date
02/17/2010
Last updated
02/23/2011
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