Individual
MALLORY A SIMONTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 PHIPPS LN, PARIS, IL 61944-2919
(217) 463-4340
Mailing address
2200 S MAIN ST, PARIS, IL 61944-2966
(217) 463-4340
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209018013
IL
363LF0000X
Family Nurse Practitioner
71007144A
IN
Other
Enumeration date
06/12/2017
Last updated
10/16/2019
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