MEDICARE: MRS. MICHELLE ANNE SIMPSON 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	363L00000X	Nurse Practitioner	1-167254	AL

General Provider Information

NPI Number	:	1376547901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE ANNE SIMPSON CRNP

Provider Business Mailing Address
First Line	:	1129 EAGLE PARK RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-6940
Country	:	US
Telephone Number	:	757-342-8992
Fax Number	:	205-383-1850

Provider Business Practice Location Address
First Line	:	1900 INTERNATIONAL PARK DR STE 200
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-4217
Country	:	US
Telephone Number	:	205-602-3931
Fax Number	:	205-383-1850

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/11/2024

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