Provider Demographics
NPI:1356640262
Name:SIMPKINS, FREDDIE LEE II (CRNA)
Entity Type:Individual
Prefix:MR
First Name:FREDDIE
Middle Name:LEE
Last Name:SIMPKINS
Suffix:II
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 PRANCER WAY
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1368
Mailing Address - Country:US
Mailing Address - Phone:904-542-7632
Mailing Address - Fax:
Practice Address - Street 1:5150 WARREN PKWY BLDG 8
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7462
Practice Address - Country:US
Practice Address - Phone:904-542-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD085247367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered