# SHARONELLE SIMMONS, M.D

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295057354
- **Authorized official:** DR. SHARONELLE SIMMONS M.D. (MEMBER/MEDICAL DIRECTOR)
- **Authorized official phone:** (480) 949-1182

## Contact information

- **Practice address:** 6200 S MCCLINTOCK DR STE 104, TEMPE, AZ 85283-3268
- **Practice address phone:** (480) 388-3666
- **Practice address fax:** (480) 388-3667
- **Mailing address:** 6200 S MCCLINTOCK DR STE 104, TEMPE, AZ 85283-3268
- **Mailing address phone:** (480) 388-3666
- **Mailing address fax:** (480) 388-3667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 13628 | AZ | Yes |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/17/2010
- **Last updated:** 02/23/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1Z7430 | HEALTHNET | — |
| 01 | — | 2569417 | AETNA | AZ |
| 01 | — | AZ0071880 | BC/BS OF AZ. | AZ |