Healthcare Provider Details

I. General information

NPI: 1588570980
Provider Name (Legal Business Name): EMMA SIMON CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

7760 MAIN ST
MIDDLETOWN VA
22645-9500
US

IV. Provider business mailing address

PO BOX 555
FRONT ROYAL VA
22630-0012
US

V. Phone/Fax

Practice location:
  • Phone: 808-285-4171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0129000241
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: