Provider Demographics
NPI:1881774677
Name:SIMONS, NANCY JANE (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JANE
Last Name:SIMONS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14070 WHISPERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3350
Mailing Address - Country:US
Mailing Address - Phone:727-656-6457
Mailing Address - Fax:727-577-0983
Practice Address - Street 1:5565 DR MARTIN LUTHER KING JR ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-1203
Practice Address - Country:US
Practice Address - Phone:727-656-6457
Practice Address - Fax:727-577-0983
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003611103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75697OtherBLUE CROSS BLUE SHIELD