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Individual

BONNEY NEILL SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
971 LAKELAND DR, JACKSON, MS 39216-4643
(601) 981-9503
(601) 981-7895
Mailing address
125 FAIRCHILD CV, CANTON, MS 39046-4414
(601) 529-0041

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
901953
MS
363LA2200X
Adult Health Nurse Practitioner
901953
MS
363LG0600X
Gerontology Nurse Practitioner
901953
MS

Other

Enumeration date
02/02/2017
Last updated
02/06/2017
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