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Individual

KELLIE SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
3401 N BROAD ST, GASTROENTEROLOGY - 3RD FL AMBULATORY CARE CENTER, PHILADELPHIA, PA 19140-5103
(215) 707-9900
(215) 707-3831
Mailing address
2450 W HUNTING PARK AVE, 3/208N, PHILADELPHIA, PA 19129-1302
(215) 707-4739
(215) 707-3677

Taxonomy

Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
SP008870
PA

Other

Enumeration date
06/01/2007
Last updated
02/18/2013
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