Individual
MS. MICHELLE SIMONSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 16TH ST, GREELEY, CO 80631-5114
(970) 350-2427
(970) 350-2421
Mailing address
1900 16TH ST, GREELEY, CO 80631-5114
(970) 350-2427
(970) 350-2421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1332
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00944819
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
02/02/2006
Last updated
06/12/2013
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