Provider Demographics
NPI:1831836055
Name:SIMONIS, JAMIE LEE (DNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:SIMONIS
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:RICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:87 S STATE ROUTE 89
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-5687
Mailing Address - Country:US
Mailing Address - Phone:928-404-1488
Mailing Address - Fax:866-232-8580
Practice Address - Street 1:87 S STATE ROUTE 89
Practice Address - Street 2:
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-5687
Practice Address - Country:US
Practice Address - Phone:928-404-1488
Practice Address - Fax:866-232-8580
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ305441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty