Provider Demographics
NPI:1013419662
Name:SIMPSON, MEGAN MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 S DOGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 S. UTICA AVE.
Practice Address - Street 2:SUITE 365
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4004
Practice Address - Country:US
Practice Address - Phone:918-728-3354
Practice Address - Fax:918-728-7554
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK85624363LF0000X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily