Individual
MS. VANESSA RENEE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL ASSISTANT
Contact information
Practice address
302B BAKER ST, FORT CAMPBELL, KY 42223
(910) 322-1993
Mailing address
302B BAKER ST, FORT CAMPBELL, KY 42223-3662
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
11/28/2017
Last updated
08/09/2018
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