Provider Demographics
NPI:1609835594
Name:SIMON, MARGARITA F (NP)
Entity Type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:F
Last Name:SIMON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 KEMPSVILLE RD
Mailing Address - Street 2:STE 204
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7300
Mailing Address - Country:US
Mailing Address - Phone:757-474-7460
Mailing Address - Fax:757-474-7455
Practice Address - Street 1:1446 KEMPSVILLE RD
Practice Address - Street 2:STE 204
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-7300
Practice Address - Country:US
Practice Address - Phone:757-474-7460
Practice Address - Fax:757-474-7455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024061179363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
002918S33Medicare ID - Type Unspecified
P00741Medicare UPIN