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General NPI Number Information
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NPI Number | 1780507921
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Entity Type | Individual
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Provider Name | JENNIFER GRACE SIMPSON RN,CBS
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 336 WARNER DR STE B
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City | LEWISTON
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State | ID
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Zip | 83501-4441
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Country | US
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Telephone | 509-552-9927
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Fax |
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Provider Business Mailing Address
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Address Line | 1458 HILLCREST WAY
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City | CLARKSTON
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State | WA
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Zip | 99403-2933
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Country | US
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Telephone | 509-780-2526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 46952
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License Number State | ID
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