Healthcare Provider Details

I. General information

NPI: 1083686448
Provider Name (Legal Business Name): MARJORIE SIMPSON PHD, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 973
WESTMINSTER MD
21158-0973
US

IV. Provider business mailing address

684 POOLE RD STE A
WESTMINSTER MD
21157-6173
US

V. Phone/Fax

Practice location:
  • Phone: 410-218-4786
  • Fax: 410-795-0029
Mailing address:
  • Phone: 667-367-2260
  • Fax: 667-367-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR108131
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: