Provider Demographics
NPI:1376598169
Name:SIMON-CHRISTIE, NATACHA (DNP, CRNA)
Entity Type:Individual
Prefix:
First Name:NATACHA
Middle Name:
Last Name:SIMON-CHRISTIE
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:NATACHA
Other - Middle Name:
Other - Last Name:SIMOIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:116 PLEASANT HILL RD NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-1437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 N DECATUR RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5918
Practice Address - Country:US
Practice Address - Phone:404-778-7408
Practice Address - Fax:404-778-3238
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN167757367500000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1376598169Medicaid
GA13765988169Medicaid
GA969129030BMedicaid
GAN332595OtherWELLCARE
GAQ23289Medicare UPIN