Healthcare Provider Details

I. General information

NPI: 1861989444
Provider Name (Legal Business Name): ALLIE SIMPSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 E WOOD ST
PARIS TN
38242-4421
US

IV. Provider business mailing address

1323 E WOOD ST
PARIS TN
38242-4421
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-2011
  • Fax:
Mailing address:
  • Phone: 731-642-2011
  • Fax: 731-644-2758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number34287
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN000215951
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: