Individual provider Active NPI

Simone Marie Cruickshank, RN

  • Registered Nurse
  • Devon, PA
National Provider Identifier
1124814074
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
711411 Issued in PA
Practice address
235 W Lancaster Ave
Devon, PA 19333-1560
Phone
(484) 551-3366
NPI assigned
Apr 17, 2025
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 711411 PA Primary

Addresses

Primary practice location

235 W Lancaster Ave
Devon, PA 19333-1560

Mailing address

235 W Lancaster Ave
Devon, PA 19333-1560
Phone (484) 551-3366

Other practice location 1

235 W Lancaster Ave
Devon, PA 19333-1560
Phone (484) 551-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
711411PAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1124814074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 W LANCASTER AVE",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331560",
            "telephone_number": "484-551-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W LANCASTER AVE",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331560",
            "telephone_number": "484-551-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 W Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Devon",
            "state": "PA",
            "postal_code": "193331560",
            "country_code": "US",
            "telephone_number": "484-551-3366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUICKSHANK",
        "first_name": "SIMONE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "711411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.