Provider Demographics
NPI:1225128317
Name:SIMPSON, WAVENEY EVADNEY (RN)
Entity Type:Individual
Prefix:MS
First Name:WAVENEY
Middle Name:EVADNEY
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USAMEDDAC WUERZBURG, UNIT 26610
Mailing Address - Street 2:ATTN: CREDENTIAL OFFICE
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09244
Mailing Address - Country:US
Mailing Address - Phone:01149-931-8043
Mailing Address - Fax:01149-931-8043
Practice Address - Street 1:USAMEDDAC WUERZBURG, UNIT 26610
Practice Address - Street 2:US ARMY HEALTH CLINIC- WUERZBURG
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09244
Practice Address - Country:US
Practice Address - Phone:01149-931-8043
Practice Address - Fax:01149-931-8043
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR108812163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN