Provider Demographics
NPI:1699159715
Name:SIMON, EMILY DANIELLE (CNS)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:DANIELLE
Last Name:SIMON
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:DANIELLE
Other - Last Name:CHEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4309
Mailing Address - Country:US
Mailing Address - Phone:214-648-3111
Mailing Address - Fax:
Practice Address - Street 1:2001 INWOOD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-4309
Practice Address - Country:US
Practice Address - Phone:214-645-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX842135364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX427968YRTEMedicare PIN
TX427968YSEDMedicare PIN