Healthcare Provider Details

I. General information

NPI: 1396855276
Provider Name (Legal Business Name): CARRIE SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 HENSLEE DR
DICKSON TN
37055-2076
US

IV. Provider business mailing address

1111 DOGWOOD LN
BURNS TN
37029-5232
US

V. Phone/Fax

Practice location:
  • Phone: 615-446-7696
  • Fax:
Mailing address:
  • Phone: 615-740-1054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4880
Identifier TypeOTHER
Identifier StateTN
Identifier IssuerLICENSE #

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: