Simon, Mary L

Simon, Mary L is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Simon, Mary L can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Phone: (608) 782-7300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1746 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1746 Wisconsin

Profile Details

NPI number 1962407320
LBN Legal business name Simon, Mary L
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Dec 29th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962407320 NPPES
Wisconsin MEDICAID 43926800

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