1447446026 NPI number — MRS. JEANIE FALLIN SIMMERING B.S.

Table of content: MRS. JEANIE FALLIN SIMMERING B.S. (NPI 1447446026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447446026 NPI number — MRS. JEANIE FALLIN SIMMERING B.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMMERING
Provider First Name:
JEANIE
Provider Middle Name:
FALLIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
B.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447446026
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2129 RAINBOW DR
Provider Second Line Business Mailing Address:
242 W SHRAMROCK AVE.
Provider Business Mailing Address City Name:
PINEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71360-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-484-6850
Provider Business Mailing Address Fax Number:
318-484-6844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2129 RAINBOW DR
Provider Second Line Business Practice Location Address:
242 W SHRAMROCK AVE.
Provider Business Practice Location Address City Name:
PINEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71360-6449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-484-6850
Provider Business Practice Location Address Fax Number:
318-484-6844
Provider Enumeration Date:
09/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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