Individual
DANYELLE RIDLEY SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(910) 709-4393
Mailing address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(910) 709-4393
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
269021
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10004210
OR
Other
Enumeration date
12/14/2022
Last updated
02/10/2023
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