Individual provider · Type 1 NPI
Samantha Laine Simon
Nurse Practitioner · Jacksonville, FL
Practice location
532 Riverside Ave Ste 103
Jacksonville, FL 32202-4914
Fax (904) 390-7483
Mailing address
PO Box 746638
Atlanta, GA 30374-6638
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | APRN11041627 (FL) |
| Family Nurse Practitioner | 363LF0000X | APRN11041627 (FL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1548112014
Samantha Laine Simon's National Provider Identifier is 1548112014, issued on Feb 9, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Jacksonville, FL. The record was last updated on May 22, 2026.