Healthcare Provider Details

I. General information

NPI: 1275589129
Provider Name (Legal Business Name): JODI A SIMPSON N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE G BUILDING, ADMINISTRATION OFFICE
BROOKLYN NY
11203-2057
US

IV. Provider business mailing address

18407 144TH AVE
SPRINGFIELD GARDENS NY
11413-3210
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-2303
  • Fax:
Mailing address:
  • Phone: 917-733-7301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number473215
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number334109
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400439
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: