Individual
MARY TABATHA SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
290 ENTERPRISE DR, EASLEY, SC 29642-8280
(864) 365-0290
Mailing address
3 PROFESSIONAL PARK DR, STE 21, JOHNSON CITY, TN 37604-6529
(423) 434-6300
(423) 434-6312
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19600
SC
363LF0000X
Family Nurse Practitioner
24643
TN
Other
Enumeration date
08/10/2015
Last updated
08/18/2025
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