Provider Demographics
NPI:1558606343
Name:SIMON-WATERMAN, CHRISTIE (DNP, RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:SIMON-WATERMAN
Suffix:
Gender:F
Credentials:DNP, RN, FNP-BC
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:SIMION-MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC, PMHNP-BC
Mailing Address - Street 1:8840 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8840 BELAIR ROAD, NOTTINGHAM, MD, USA
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:443-883-1826
Practice Address - Fax:443-572-4186
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR158201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily