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SIMONE BLACKBURN
NPI 1669309464
Nurse Practitioner - Women's Health in Philadelphia, PA

Active since May 06, 2026
111 S 11TH ST, PHILADELPHIA, PA 19107(714) 655-9299 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Simone Blackburn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIMONE BLACKBURN (NPI 1669309464) is an individual women's health provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP032163) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1669309464
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameSIMONE BLACKBURN
Location Address111 S 11TH STPhiladelphia, PA 19107-4870
Mailing Address4224 Otter StreetPhiladelphia, PA 19104 · (714) 655-9299
Phone(714) 655-9299
Sole ProprietorNo
Enumeration DateMay 6, 2026
NPPES CertifiedMay 1, 2026
✔ NPI 1669309464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in PA · SP032163
111 S 11TH ST, Philadelphia, PA 19107
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE LYNN RENALDI D.O.
Anesthesiology
111 S 11TH ST, SUITE 8490
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6161
LING FAN
Nurse Practitioner (Acute Care)
111 S 11TH ST, GIBBON BLDG., SUITE 6270
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-8304
WILLIAM JUSTICE MD
Student in an Organized Health Care Education/Training Program
111 S 11TH ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 995-6000
DR. DAVID P. FRIEDMAN M.D.
Radiology (Diagnostic Radiology)
111 S 11TH ST, SUITE 3390
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-2900
DR. WALTER K. KRAFT M.D.
Internal Medicine
111 S 11TH ST, SUITE 6270
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6540
DR. TAKI GALANIS M.D.
Internal Medicine
111 S 11TH ST, SUITE 6270
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6540
DR. STEVEN M LUDWIN M.D.
Internal Medicine
111 S 11TH ST, SUITE 2170
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6610
JENNIFER L SWOPE CRNA
Nurse Anesthetist, Certified Registered
111 S 11TH ST, SUITE 8490
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6161

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simone Blackburn's NPI number?

The NPI number for Simone Blackburn is 1669309464. It was assigned to this individual provider in the NPPES registry on May 6, 2026.

Where is Simone Blackburn located?

Simone Blackburn practices at 111 S 11th St, Philadelphia, PA 19107. The listed phone number is (714) 655-9299.

What is Simone Blackburn's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

When was this NPI record last updated?

The NPPES record for Simone Blackburn was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.