Healthcare Provider Details

I. General information

NPI: 1427719897
Provider Name (Legal Business Name): NANCY ELAINE SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 S MAIN ST
LAYTON UT
84041-7135
US

IV. Provider business mailing address

3280 W 3500 S STE E
WEST VALLEY CITY UT
84119-2668
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-7060
  • Fax: 801-336-1787
Mailing address:
  • Phone: 801-979-1351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number6026818-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: