Healthcare Provider Details

I. General information

NPI: 1376456772
Provider Name (Legal Business Name): PHANESSA SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6408 5TH ST NW
WASHINGTON DC
20012-2712
US

IV. Provider business mailing address

6408 5TH ST NW
WASHINGTON DC
20012-2712
US

V. Phone/Fax

Practice location:
  • Phone: 470-234-0493
  • Fax:
Mailing address:
  • Phone: 470-234-0493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: