Individual
SHEA WILSON SIMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8706
(270) 956-0211
Mailing address
280 GEORGETOWN CIR, ELKTON, KY 42220-9327
(270) 265-9775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA521
KY
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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