Individual
LAURA JANE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
260 LAKEMONT DR, FAYETTEVILLE, GA 30215-2344
(770) 363-1274
(770) 716-1580
Mailing address
260 LAKEMONT DR, FAYETTEVILLE, GA 30215-2344
(770) 363-1274
(770) 716-1580
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN149745
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280727326A
—
GA
Enumeration date
07/19/2010
Last updated
07/15/2013
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