Provider Demographics
NPI:1528592847
Name:SIMPSON, HEATHER (FNP BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 VANDEVENTER CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2708
Mailing Address - Country:US
Mailing Address - Phone:973-224-1033
Mailing Address - Fax:
Practice Address - Street 1:39 VANDEVENTER CT
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-2708
Practice Address - Country:US
Practice Address - Phone:973-224-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00715300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily