Provider Demographics
NPI:1295361616
Name:SIMONSON, NICOLE BEATRICE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:BEATRICE
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:BEATRICE
Other - Last Name:BRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:686 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723
Mailing Address - Country:US
Mailing Address - Phone:732-262-8200
Mailing Address - Fax:732-262-8203
Practice Address - Street 1:484 TEMPLE HILL ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553
Practice Address - Country:US
Practice Address - Phone:732-262-8200
Practice Address - Fax:732-262-8203
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01012300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily