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NPI Code Detail

MEDICARE: JERMAINE SIMPKINS M.A

MEDICARE: JERMAINE SIMPKINS M.A
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
1225400000XRehabilitation Practitioner
2101YM0800XMental Health CounselorOR

General Provider Information

NPI Number : 1972979334
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERMAINE SIMPKINS M.A
Provider Business Mailing Address
First Line : PO BOX 1121
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-0254
Country : US
Telephone Number : 702-427-1195
Fax Number :
Provider Business Practice Location Address
First Line : 3005 NE DIAMOND LAKE BLVD
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-3609
Country : US
Telephone Number : 702-427-1195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2015
Last Update Date : 06/11/2024

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Directions to “ JERMAINE SIMPKINS M.A” Practice Location

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