Provider Demographics
NPI:1962738005
Name:SIMONS, SHIRLEY (APRN)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:SIMONS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 NORTON HEALTHCARE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2831
Mailing Address - Country:US
Mailing Address - Phone:502-446-8660
Mailing Address - Fax:502-446-8665
Practice Address - Street 1:4960 NORTON HEALTHCARE BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2831
Practice Address - Country:US
Practice Address - Phone:502-446-8660
Practice Address - Fax:502-446-8665
Is Sole Proprietor?:No
Enumeration Date:2009-10-24
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily