Provider Demographics
NPI:1023195765
Name:SIMPSON, CHRISTINE S (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:S
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 1:45 WILDEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5354
Mailing Address - Country:US
Mailing Address - Phone:203-874-7790
Mailing Address - Fax:
Practice Address - Street 1:45 WILDEMERE AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-5354
Practice Address - Country:US
Practice Address - Phone:203-874-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001575363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT890000238Medicare ID - Type Unspecified