Healthcare Provider Details

I. General information

NPI: 1962466391
Provider Name (Legal Business Name): ALLISON I SIMON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5073 MAIN ST SUITE 100
SPRING HILL TN
37174-2737
US

IV. Provider business mailing address

1195 OLD HICKORY BLVD SUITE 103
BRENTWOOD TN
37027-4239
US

V. Phone/Fax

Practice location:
  • Phone: 615-302-0885
  • Fax: 615-891-5003
Mailing address:
  • Phone: 615-373-2000
  • Fax: 615-891-5021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000011036
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: