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NPI Code Detail

MEDICARE: LISA Y SIMPSON FNM-BC

MEDICARE: LISA Y SIMPSON FNM-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
1363LF0000XFamily Nurse Practitioner0017140241VA
2363LF0000XFamily Nurse Practitioner0024169652VA

General Provider Information

NPI Number : 1336425891
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA Y SIMPSON FNM-BC
Provider Business Mailing Address
First Line : 100 KNOTBREAK RD
Second Line :
City : SALEM
State : VA
Zip : 24153-5414
Country : US
Telephone Number : 540-444-5670
Fax Number : 540-444-5669
Provider Business Practice Location Address
First Line : 100 KNOTBREAK RD
Second Line :
City : SALEM
State : VA
Zip : 24153-5414
Country : US
Telephone Number : 540-444-5670
Fax Number : 540-444-5669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2011
Last Update Date : 09/15/2025

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