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NPI Code Detail

MEDICARE: DR. NANCY JANE SIMONS PH.D.

MEDICARE: DR. NANCY JANE SIMONS PH.D.
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
1103T00000XPsychologistPY0003611FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
175697OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1881774677
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY JANE SIMONS PH.D.
Provider Business Mailing Address
First Line : 14070 WHISPERWOOD DR
Second Line :
City : CLEARWATER
State : FL
Zip : 33762-3350
Country : US
Telephone Number : 727-656-6457
Fax Number : 727-577-0983
Provider Business Practice Location Address
First Line : 5565 DR MARTIN LUTHER KING JR ST N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33703-1203
Country : US
Telephone Number : 727-656-6457
Fax Number : 727-577-0983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 07/08/2007

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