Provider Demographics
NPI:1063001212
Name:SIMPSON, CHELSEA LYNN (CBS)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 PREHISTORIC HILL DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-2290
Mailing Address - Country:US
Mailing Address - Phone:916-953-3779
Mailing Address - Fax:
Practice Address - Street 1:1533 PREHISTORIC HILL DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-2290
Practice Address - Country:US
Practice Address - Phone:916-953-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN