Provider Demographics
NPI:1629216221
Name:SIMPSON, ANITA M (NP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 LYNCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-2998
Mailing Address - Country:US
Mailing Address - Phone:812-867-9800
Mailing Address - Fax:812-867-4720
Practice Address - Street 1:2330 LYNCH RD STE 100
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-2998
Practice Address - Country:US
Practice Address - Phone:812-867-9800
Practice Address - Fax:812-867-4720
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002868A363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100381900Medicaid
IN200984040Medicaid
INM400062113Medicare PIN
IN229920002Medicare PIN
IN200984040Medicaid
KY7100381900Medicaid