Provider Demographics
NPI:1730701830
Name:SIMMONS-HALL, SHAKANA LASHEA (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHAKANA
Middle Name:LASHEA
Last Name:SIMMONS-HALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13750 W. COLONIAL DRIVE SUITE 350 #247
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787
Mailing Address - Country:US
Mailing Address - Phone:407-803-3706
Mailing Address - Fax:
Practice Address - Street 1:115 JAKE CT
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4418
Practice Address - Country:US
Practice Address - Phone:407-803-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG01200157363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health