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Individual
JENNIFER C. SIMON
Active
Individual
JENNIFER C. SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
58536
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006265
—
WV
01
—
9328803
GROUP PTAN
WV
01
—
WV0245A
PTAN
WV
Enumeration date
08/15/2006
Last updated
09/08/2011
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