Healthcare Provider Details

I. General information

NPI: 1013356203
Provider Name (Legal Business Name): DAPHNE J SIMPSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 S HICKORY TER
SPRINGFIELD MO
65809-1105
US

IV. Provider business mailing address

761 S HICKORY TER
SPRINGFIELD MO
65809-1105
US

V. Phone/Fax

Practice location:
  • Phone: 417-350-9151
  • Fax:
Mailing address:
  • Phone: 417-350-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2013019749
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: