Healthcare Provider Details

I. General information

NPI: 1366793168
Provider Name (Legal Business Name): CATHERINE SIMEON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34290 FORD RD
WESTLAND MI
48185-3051
US

IV. Provider business mailing address

47370 BAKER ST
NOVI MI
48374-3669
US

V. Phone/Fax

Practice location:
  • Phone: 734-412-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License Number4704293777
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704293777
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: