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General NPI Number Information
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NPI Number | 1689551186
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Entity Type | Individual
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Provider Name | JOSEPH RONALD SIMON
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Gender | Male
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 10101 S 27TH ST
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City | FRANKLIN
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State | WI
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Zip | 53132-7209
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Country | US
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Telephone | 414-817-5800
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Fax |
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Provider Business Mailing Address
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Address Line | W267N7141 WHITE OAK DR
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City | SUSSEX
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State | WI
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Zip | 53089-2433
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Country | US
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Telephone | 801-814-5665
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 17292-33
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License Number State | WI
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