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Organization
QUICKCARENP
Active
Organization
QUICKCARENP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUTUM FABRE SIMMONS FNP (OWNER/NURSE PRACTITIONER)
(757) 330-0222
Entity
Organization
Contact information
Practice address
719 HIGH ST, PORTSMOUTH, VA 23704-3425
(757) 330-0222
Mailing address
49 PROSPECT PKWY, PORTSMOUTH, VA 23702-2831
(224) 578-3182
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024175436
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
951022
AENTA
VA
01
—
QCN23702
AETNA
VA
Enumeration date
03/16/2018
Last updated
08/24/2022
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