Provider Demographics
NPI:1467749325
Name:SIMPSON, MEGHAN R (CRNA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:R
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8574 BANYAN BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-8505
Mailing Address - Country:US
Mailing Address - Phone:239-292-6403
Mailing Address - Fax:
Practice Address - Street 1:6241 ARC WAY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1352
Practice Address - Country:US
Practice Address - Phone:239-278-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9219664367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered