Provider Demographics
NPI:1326339698
Name:SIMPSON, PAMELA (L P N)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:L P N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12406 CORLETT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-2908
Mailing Address - Country:US
Mailing Address - Phone:216-921-8215
Mailing Address - Fax:216-921-8215
Practice Address - Street 1:12406 CORLETT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-2908
Practice Address - Country:US
Practice Address - Phone:216-921-8215
Practice Address - Fax:216-921-8215
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.143740-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse