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NPI Code Detail

MEDICARE: SARAH SIMON

MEDICARE: SARAH SIMON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner7544-33WI
2363L00000XNurse Practitioner7544-33WI

General Provider Information

NPI Number : 1831638212
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH SIMON
Provider Business Mailing Address
First Line : 335 E MAHN CT
Second Line :
City : OAK CREEK
State : WI
Zip : 53154-2155
Country : US
Telephone Number : 414-762-2020
Fax Number : 414-762-2024
Provider Business Practice Location Address
First Line : 7793 W APPLETON AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2009
Country : US
Telephone Number : 414-393-9810
Fax Number : 414-393-9817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2017
Last Update Date : 12/08/2021

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Directions to “ SARAH SIMON ” Practice Location

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