Provider Demographics
NPI:1093528366
Name:SIMONS, JORDYN (CRNP)
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:
Last Name:SIMONS
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 PENN AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3017
Mailing Address - Country:US
Mailing Address - Phone:484-513-3793
Mailing Address - Fax:484-509-5122
Practice Address - Street 1:932 PENN AVE FL 1
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3017
Practice Address - Country:US
Practice Address - Phone:484-513-3793
Practice Address - Fax:484-509-5122
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031962363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health