Healthcare Provider Details

I. General information

NPI: 1356190979
Provider Name (Legal Business Name): ASHLEY NICOLE SIMPSON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 PADDOCK WAY
SUMMERVILLE SC
29486-8218
US

IV. Provider business mailing address

758 SILVER BLUFF RD UNIT 5037
AIKEN SC
29803-4018
US

V. Phone/Fax

Practice location:
  • Phone: 843-640-0812
  • Fax:
Mailing address:
  • Phone: 803-598-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28579
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: