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JACQUELINE DEBORAH SIMON APRN PMHNP-BC NPI 1497200307


NPI Information

NPI: 1497200307
Provider Name: JACQUELINE DEBORAH SIMON, APRN, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
7789 NW BEACON SQUARE BLVD
BOCA RATON, FL
ZIP 33487
Phone: (561) 241-7977
Get Directions

Jacqueline Deborah Simon, APRN, PMHNP-BC is a psychiatric/mental health nurse practitioner in Boca Raton, FL. Jacqueline Deborah Simon, APRN, PMHNP-BC NPI is 1497200307. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7789 NW BEACON SQUARE BLVD
BOCA RATON, FL
ZIP 33487-326
Phone: (561) 241-7977
Fax: (561) 405-2087

The NPI 1497200307 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/20/2016 and was last updated on 7/16/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN9328821FLORIDAYes
2364SP0808XClinical Nurse SpecialistPsychiatric/Mental HealthAPRN9328821FLORIDANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1101264100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.