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General NPI Number Information
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NPI Number | 1962391482
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Entity Type | Individual
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Provider Name | NICOLE M SIMPSON N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | SOUTH BELOIT CLINIC 1701 BLACKHAWK BLVD
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City | SOUTH BELOIT
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State | IL
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Zip | 61080
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Country | US
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Telephone | 815-389-2268
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Fax | 815-525-4350
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Provider Business Mailing Address
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Address Line | SOUTH BELOIT CLINIC 1701 BLACKHAWK BLVD
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City | SOUTH BELOIT
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State | IL
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Zip | 61080
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Country | US
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Telephone | 815-389-2268
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Fax | 815-525-4350
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 16836-33
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License Number State | WI
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