STACY LYNN SIMONS


Address: 400 Mack Ave, Detroit, MI 48201-2136
Phone: 8772278823

STACY LYNN SIMONS (NPI# 1558716324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558716324
Entity Type Individual
Full Name STACY LYNN SIMONS
Other Name STACY LYNN BECKER
Credential AGPCNP-BC
Practice Address 400 Mack Ave
Detroit
MI 48201-2136
Mailing Address 2366 Oak Valley Dr
Ann Arbor
MI 48103-8944
Practice Telephone 8772278823
Mailing Telephone 7346625999
Enumeration Date 2016-04-29
Last Update Date 2016-11-18
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 4704244140 MI Nursing Service Providers
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
4704244140 MI Physician Assistants & Advanced Practice Nursing Providers

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1548629371 Stacy Simons Massage Therapist 103 Morris St Ste V, Sebastopol, CA 95472 2016-02-22
1952844185 Stacy Simons Nurse Practitioner 4318 Mission Ave, Oceanside, CA 92057-6541 2016-11-20

Office Location

Street Address 400 MACK AVE
City DETROIT
State MI
Zip Code 48201-2136

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154306355 John W Finn Internal Medicine 400 Mack Ave, Detroit, MI 48201-2136 2005-12-09
1760015622 Wayne Pediatrics Inc. Pediatrics 400 Mack Ave, Detroit, MI 48201-2136 2020-02-19
1467857649 Furha Shuttari Nurse Practitioner 400 Mack Ave, Detroit, MI 48201-2136 2014-10-29
1851410617 Terri Lynne Mack Internal Medicine 400 Mack Ave, Detroit, MI 48201-2136 2007-03-29
1164541447 Supportive Care Services of Michigan Inc Nursing Care 400 Mack Ave, Detroit, MI 48201-2136 2007-03-28
1639221401 Marilyn Elizabeth Remillard Nurse Practitioner 400 Mack Ave, Detroit, MI 48201-2136 2007-01-18
1760453195 Michael Joseph Paletta Internal Medicine 400 Mack Ave, Detroit, MI 48201-2136 2006-02-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659989838 Saima Sharif Student in an Organized Health Care Education/Training Program 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 2020-07-14
1609494384 Praveen Kumar Boddu Student in an Organized Health Care Education/Training Program 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 2020-07-09
1730707720 Amr Hassan Abdelghaffar Omar Pediatrics 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 2020-07-07
1700400694 Hassan Imtiaz Student in an Organized Health Care Education/Training Program 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 2020-06-05
1598389074 Alaa Awad Elkarim Student in an Organized Health Care Education/Training Program 3901 Beaubien St. 3t72, Detroit, MI 48201 2020-06-01
1891319299 Jeongyeon Hwang Student in an Organized Health Care Education/Training Program 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 2020-06-01
1477176576 Jaudat Fatima Masood Student in an Organized Health Care Education/Training Program 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 2020-05-22
1205459419 Amit Kumar Dahiya Student in an Organized Health Care Education/Training Program 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 2020-05-21
1851914188 Asra Nausheen Shaik Student in an Organized Health Care Education/Training Program 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 2020-05-21
1568085751 Camille Olechowski Student in an Organized Health Care Education/Training Program 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 2020-05-21
Find all providers in zip 48201

Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750808648 Mattie B. Johnson Nurse Practitioner 13599 Virgil St, Detroit, MI 48223-3050 2017-08-23
1184176984 Amanda Marie Allmacher Nurse Practitioner 50 E Canfield St Ste 101-s, Detroit, MI 48201-1804 2016-10-27
1144774472 Angela Jayne Wolf Nurse Practitioner 7409 2nd Ave, Apt. A2, Detroit, MI 48202-2700 2016-08-03
1912263914 Tonia Anitra Willis Nurse Practitioner 14102 Saint Marys St, Detroit, MI 48227 2012-04-04
1861624058 Angela Faye Woodley-williams Nurse Practitioner 11260 E Jefferson Ave, Detroit, MI 48214-3320 2009-08-20
1740394055 Mary Patricia Lange Nurse Practitioner 4601 John R, Detroit, MI 48201 2006-08-17
1346848827 Tanya L Locke Nurse Practitioner 22101 Moross Rd, Detroit, MI 48236-2148 2020-10-15
1720621279 Rachel Campbell Nurse Practitioner 5716 Michigan Ave, Detroit, MI 48210-3039 2019-10-28
1124679188 Shanta Nicole Brown Nurse Practitioner 16181 Hubbell St, Detroit, MI 48235-4026 2019-09-21
1851866396 Christopher Childers Nurse Practitioner 4160 John R St Ste 930, Detroit, MI 48201-2017 2018-10-11
Find all providers in DETROIT

Competitor

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City DETROIT
Zip Code 48201

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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