Individual
JENNIFER L SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14700 LAKE SHORE DR, CHARLEVOIX, MI 49720-1999
(231) 547-4024
Mailing address
10171 E SHORESIDE CT, TRAVERSE CITY, MI 49684-9567
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704246607
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679894117
—
MI
Enumeration date
06/18/2010
Last updated
04/13/2026
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