Basic Information
| Provider Information | |||||||||
| NPI: | 1437541661 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMONS | ||||||||
| FirstName: | KAY | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12633 N 25TH AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850292533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028825725 | ||||||||
| FaxNumber: | 6023961210 | ||||||||
| Practice Location | |||||||||
| Address1: | 1035 E JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850342295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022510650 | ||||||||
| FaxNumber: | 6023961210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2015 | ||||||||
| LastUpdateDate: | 02/25/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN083805 | AZ | Y | Nursing Service Providers | Registered Nurse |
No ID Information.