Healthcare Provider Details

I. General information

NPI: 1255186201
Provider Name (Legal Business Name): MELISSA C SIMPSON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 PLAINFIELD RD UNIT 5
WEST LEBANON NH
03784-2001
US

IV. Provider business mailing address

4 KENYON ST
CLAREMONT NH
03743-2824
US

V. Phone/Fax

Practice location:
  • Phone: 603-298-2146
  • Fax:
Mailing address:
  • Phone: 603-477-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number016342-22
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: