Individual
KRYSTLE M SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 DERRIES RD, AWENDAW, SC 29429-6057
(843) 310-9517
Mailing address
1020 DERRIES RD, AWENDAW, SC 29429-6057
(843) 310-9517
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
9991507
SC
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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