Healthcare Provider Details

I. General information

NPI: 1629216221
Provider Name (Legal Business Name): ANITA M SIMPSON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 LYNCH RD STE 100
EVANSVILLE IN
47711-2998
US

IV. Provider business mailing address

2330 LYNCH RD STE 100
EVANSVILLE IN
47711-2998
US

V. Phone/Fax

Practice location:
  • Phone: 812-867-9800
  • Fax: 812-867-4720
Mailing address:
  • Phone: 812-867-9800
  • Fax: 812-867-4720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71002868A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002868A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: