Provider Demographics
NPI:1376256222
Name:SIMPSON, BAILEY ANN
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ANN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 STATE ROUTE 68
Mailing Address - Street 2:
Mailing Address - City:EAST BRADY
Mailing Address - State:PA
Mailing Address - Zip Code:16028-3307
Mailing Address - Country:US
Mailing Address - Phone:814-229-7755
Mailing Address - Fax:
Practice Address - Street 1:165 BUTLER RD
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2329
Practice Address - Country:US
Practice Address - Phone:724-543-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DONOTHAVEOtherDO NOT HAVE