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General NPI Number Information
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NPI Number | 1578235487
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Entity Type | Individual
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Provider Name | REBECCA SIMON M.S.N., F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 6100 PAN AMERICAN FREEWAY NE STE 450 OBSTETRICS AND GYNECOLOGY
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City | ALBUQUERQUE
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State | NM
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Zip | 87109
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Country | US
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Telephone | 505-823-8787
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Fax | 505-823-8788
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1054695
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 78352
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License Number State | NM
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