MEDICARE: DR. MARJORIE SIMPSON PHD, CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	R108131	MD

General Provider Information

NPI Number	:	1083686448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARJORIE SIMPSON PHD, CRNP

Provider Business Mailing Address
First Line	:	684 POOLE RD STE A
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-6173
Country	:	US
Telephone Number	:	667-367-2260
Fax Number	:	667-367-2262

Provider Business Practice Location Address
First Line	:	PO BOX 973
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21158-0973
Country	:	US
Telephone Number	:	410-218-4786
Fax Number	:	410-795-0029

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	10/08/2018

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