Provider Demographics
NPI:1083968226
Name:SIMPSON, SARA BRANTLEY (APRN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BRANTLEY
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 1:615 E PRINCETON ST STE 310
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1468
Mailing Address - Country:US
Mailing Address - Phone:407-303-5781
Mailing Address - Fax:407-303-5794
Practice Address - Street 1:615 E PRINCETON ST STE 310
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1468
Practice Address - Country:US
Practice Address - Phone:407-303-5781
Practice Address - Fax:407-303-5794
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9277140364SP0200X
FLAPRN9277140363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics