Healthcare Provider Details

I. General information

NPI: 1245168665
Provider Name (Legal Business Name): KAREN AMANDA SIMONEAU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9313 MEDICAL PLAZA DR STE 202
CHARLESTON SC
29406-9176
US

IV. Provider business mailing address

2804 BOTTLE BRUSH CT
MOUNT PLEASANT SC
29466-9202
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-1200
  • Fax: 843-553-0424
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number31845
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: