Provider Demographics
NPI:1063854768
Name:SIMPSON, JENNIFER M (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
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 1:1340 SILVER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1844
Mailing Address - Country:US
Mailing Address - Phone:402-277-0030
Mailing Address - Fax:
Practice Address - Street 1:24110 W DODGE RD
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:NE
Practice Address - Zip Code:68069-4705
Practice Address - Country:US
Practice Address - Phone:402-297-4861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111548363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068731785Medicaid
IA1063854768Medicaid
NE10026293200Medicaid
NE47068731785Medicaid