Healthcare Provider Details

I. General information

NPI: 1245823400
Provider Name (Legal Business Name): ANNABEL A SIMPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3327 YELLOW FLOWER RD
LAUREL MD
20724-3202
US

IV. Provider business mailing address

3327 YELLOW FLOWER RD
LAUREL MD
20724-3202
US

V. Phone/Fax

Practice location:
  • Phone: 240-645-2197
  • Fax:
Mailing address:
  • Phone: 240-645-2197
  • Fax: 410-946-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00148664
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: