Provider Demographics
NPI:1447746011
Name:SIMPSON, CAROL JEAN (DNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 CHERRY VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUOLOMNE
Mailing Address - State:CA
Mailing Address - Zip Code:95379-9506
Mailing Address - Country:US
Mailing Address - Phone:520-603-4340
Mailing Address - Fax:
Practice Address - Street 1:637 MERCED ST
Practice Address - Street 2:
Practice Address - City:NEWMAN
Practice Address - State:CA
Practice Address - Zip Code:95360-1070
Practice Address - Country:US
Practice Address - Phone:209-862-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-07
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019842363LA2200X, 363LG0600X
CANP95021086363LA2200X, 363LG0600X
AZAP11354363LA2200X, 363LG0600X
NMCNP54750363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP11354OtherADULT GERIONTOLOGICAL PRIMARY NURSE PRACTITIONER
AZRN184374OtherRN