Provider Demographics
NPI:1487095931
Name:SIMON, MARGAUX ROSE (NP)
Entity type:Individual
Prefix:
First Name:MARGAUX
Middle Name:ROSE
Last Name:SIMON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 FAYETTEVILLE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5333
Mailing Address - Country:US
Mailing Address - Phone:919-551-5800
Mailing Address - Fax:919-336-4725
Practice Address - Street 1:5720 FAYETTEVILLE RD STE 203
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5333
Practice Address - Country:US
Practice Address - Phone:919-551-5800
Practice Address - Fax:919-336-4725
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172791363LF0000X
NC5006298363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily