Provider Demographics
NPI:1184295776
Name:SIMON, SARAH CHRISTINE (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CHRISTINE
Last Name:SIMON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2107
Mailing Address - Country:US
Mailing Address - Phone:806-468-4350
Mailing Address - Fax:806-468-4351
Practice Address - Street 1:1901 MEDI PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2107
Practice Address - Country:US
Practice Address - Phone:806-468-4350
Practice Address - Fax:806-468-4351
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1046555363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily