MEDICARE: MRS. KARI ANN SIMPSON COY FNP-BC

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	363LF0000X	Family Nurse Practitioner	377001638	IL
2	363LF0000X	Family Nurse Practitioner	277001691	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F400353282	OTHER	IL	MEDICARE PTAN

General Provider Information

NPI Number	:	1194991315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARI ANN SIMPSON COY FNP-BC

Provider Business Mailing Address
First Line	:	607 SHELBY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-3268
Country	:	US
Telephone Number	:	617-874-5208
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 SHELBY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-3268
Country	:	US
Telephone Number	:	617-874-5208
Fax Number	:

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

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	04/15/2026

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