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General NPI Number Information
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NPI Number | 1699130377
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Entity Type | Individual
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Provider Name | BLESSY SIMON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 411 E MCDERMOTT DR
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City | ALLEN
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State | TX
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Zip | 75002-2854
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Country | US
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Telephone | 972-227-3464
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Fax |
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Provider Business Mailing Address
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Address Line | 12411 SHUMARD LN
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City | FRISCO
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State | TX
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Zip | 75035-0453
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Country | US
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Telephone | 214-418-2585
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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 | AP129825
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License Number State | TX
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