Provider Demographics
NPI:1902292667
Name:SIMONEAU, EMILY K (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:SIMONEAU
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6935 NORTHBURY LN APT 1424
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-9604
Mailing Address - Country:US
Mailing Address - Phone:704-778-8098
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE STE 509
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1326
Practice Address - Country:US
Practice Address - Phone:412-802-3043
Practice Address - Fax:412-692-4950
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007575363L00000X, 363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care