Individual
LAURA SPENCER SIMEONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3601 CCI DR NW, HUNTSVILLE, AL 35805-2606
(256) 705-4224
(256) 705-4135
Mailing address
PO BOX 18428, HUNTSVILLE, AL 35804-8428
(256) 705-4224
(256) 705-4135
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA748
AL
363AM0700X
Medical Physician Assistant
PA.748
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135315
—
AL
Enumeration date
02/02/2011
Last updated
04/01/2014
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