Provider Demographics
NPI:1609103662
Name:SIMONEAU, JAMIE N (RN/CS)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:N
Last Name:SIMONEAU
Suffix:
Gender:F
Credentials:RN/CS
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Other - Credentials:
Mailing Address - Street 1:279 LINCOLN ST
Mailing Address - Street 2:UMASS MEMORIAL MED CTR, AMBULATORY PSYCHIATRY SERVICE
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2120
Mailing Address - Country:US
Mailing Address - Phone:508-334-2537
Mailing Address - Fax:508-334-3000
Practice Address - Street 1:279 LINCOLN ST
Practice Address - Street 2:UMASS MEMORIAL MED CTR, AMBULATORY PSYCHIATRY SERVICE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2120
Practice Address - Country:US
Practice Address - Phone:508-334-2537
Practice Address - Fax:508-334-3000
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2014-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN266987364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health