Healthcare Provider Details
I. General information
NPI: 1851759286
Provider Name (Legal Business Name): JESSI PLUMBLEE SIMPSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/30/2016
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 CHILDRENS LN
NORFOLK VA
23507-1910
US
IV. Provider business mailing address
811 REDGATE AVE
NORFOLK VA
23507-1515
US
V. Phone/Fax
- Phone: 757-668-7007
- Fax: 757-668-8658
- Phone: 757-668-7007
- Fax: 757-668-8658
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0024173209 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: