Provider Demographics
NPI:1558709832
Name:MARTIN, SIMONE CHRISTINE (APRN)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:CHRISTINE
Last Name:MARTIN
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 1:5500 PINE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3389
Mailing Address - Country:US
Mailing Address - Phone:402-489-8888
Mailing Address - Fax:402-421-1945
Practice Address - Street 1:5500 PINE LAKE RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3389
Practice Address - Country:US
Practice Address - Phone:402-489-8888
Practice Address - Fax:402-421-1945
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111493363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care