Provider Demographics
NPI:1811482003
Name:SIMON, BETH ANN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SIMON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:HAVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1170
Mailing Address - Country:US
Mailing Address - Phone:740-845-7500
Mailing Address - Fax:
Practice Address - Street 1:164 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:OH
Practice Address - Zip Code:43143-1145
Practice Address - Country:US
Practice Address - Phone:740-956-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022972207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine