Healthcare Provider Details

I. General information

NPI: 1700846599
Provider Name (Legal Business Name): TIFFANY SIMPSON-VASSALL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY SIMPSON

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17487 S HEALTHCARE DR
LAVEEN AZ
85339-8500
US

IV. Provider business mailing address

PO BOX 115
SACATON AZ
85147-0002
US

V. Phone/Fax

Practice location:
  • Phone: 520-550-6000
  • Fax: 520-550-6027
Mailing address:
  • Phone: 520-796-2600
  • Fax: 602-528-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN109710
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP1935
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: