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General NPI Number Information
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NPI Number | 1982904777
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Entity Type | Individual
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Provider Name | KELLY S. SIMPSON PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 100 S BROADWAY ST
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City | GLASGOW
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State | KY
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Zip | 42141-2604
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Country | US
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Telephone | 270-861-0606
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Fax | 270-629-2444
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Provider Business Mailing Address
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Address Line | 1005 HWY 22 EAST TRIAD HEALTH SYSTEMS
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City | OWENTON
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State | KY
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Zip | 40359
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Country | US
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Telephone | 502-547-1010
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Fax | 859-567-1253
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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 | 3006619
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3006619
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License Number State | KY
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