Provider Demographics
NPI:1417695313
Name:DURRANI-SIMMONS, SANA
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:DURRANI-SIMMONS
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 1:2185 E HOWE AVE APT F-2010
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-0954
Mailing Address - Country:US
Mailing Address - Phone:708-846-9118
Mailing Address - Fax:
Practice Address - Street 1:16716 E PALISADES BLVD STE 101A
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3846
Practice Address - Country:US
Practice Address - Phone:480-587-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-22
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ011731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program