Provider Demographics
NPI:1518137470
Name:SIMPSON-HARRIS, SANDRA ANNE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ANNE
Last Name:SIMPSON-HARRIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9349 KEEFE DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7641
Mailing Address - Country:US
Mailing Address - Phone:916-230-2589
Mailing Address - Fax:
Practice Address - Street 1:9349 KEEFE DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7641
Practice Address - Country:US
Practice Address - Phone:916-230-2589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN211070164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse