Provider Demographics
NPI:1710594809
Name:SIMCOX, VONNA JEAN
Entity type:Individual
Prefix:
First Name:VONNA
Middle Name:JEAN
Last Name:SIMCOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71220 SKYVIEW DR # 2
Mailing Address - Street 2:
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-2316
Mailing Address - Country:US
Mailing Address - Phone:740-633-3834
Mailing Address - Fax:
Practice Address - Street 1:71220 SKYVIEW DR # 2
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-2316
Practice Address - Country:US
Practice Address - Phone:740-633-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276246Medicaid