Healthcare Provider Details

I. General information

NPI: 1568284271
Provider Name (Legal Business Name): LELIA MARIE SIMPSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 S SIXTH ST
BAY SPRINGS MS
39422-9052
US

IV. Provider business mailing address

310 VIRGIL ST
TAYLORSVILLE MS
39168-5658
US

V. Phone/Fax

Practice location:
  • Phone: 601-764-2155
  • Fax: 601-764-2150
Mailing address:
  • Phone: 601-842-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907037
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: