Healthcare Provider Details

I. General information

NPI: 1356266969
Provider Name (Legal Business Name): LORI ANN SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10620 CORPORATE DR STE A
FORT WAYNE IN
46845-1711
US

IV. Provider business mailing address

1513 PION RD
FORT WAYNE IN
46845-9199
US

V. Phone/Fax

Practice location:
  • Phone: 260-266-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number28219053A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: