Individual
SHELLEY BOWEN SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7611 SAINT ANDREWS RD, IRMO, SC 29063-2834
(803) 714-3300
(803) 626-9356
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22989
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6114
—
SC
Enumeration date
06/28/2019
Last updated
06/10/2021
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