Individual
SARA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 LANSING AVE, JACKSON, MI 49202-1621
(517) 783-5127
Mailing address
3300 LANSING AVE, JACKSON, MI 49202-1621
(517) 783-5127
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116704
MI
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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