Provider Demographics
NPI:1366495103
Name:SIMPSON, ELIZABETH A (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N CELIA AVE
Mailing Address - Street 2:ATTN: DEBERA BARKER
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-4609
Mailing Address - Country:US
Mailing Address - Phone:765-282-8905
Mailing Address - Fax:
Practice Address - Street 1:349 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47320-1705
Practice Address - Country:US
Practice Address - Phone:765-751-3152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000542A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200168110Medicaid
INP00930227Medicare PIN
IN200168110Medicaid
INM400022488Medicare PIN