# JENNIFER C. SIMON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1013920347
- **Gender:** F
- **Credential:** CFNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 58536 | WV | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 09/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3810006265 | — | WV |
| 01 | — | 9328803 | GROUP PTAN | WV |
| 01 | — | WV0245A | PTAN | WV |