Provider Demographics
NPI:1639636756
Name:SIMPSON, GEORGIANNE SHELBY (RN)
Entity Type:Individual
Prefix:
First Name:GEORGIANNE
Middle Name:SHELBY
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:GEORGIANNE
Other - Middle Name:SHELBY
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 N 102ND ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2122
Mailing Address - Country:US
Mailing Address - Phone:619-284-4496
Mailing Address - Fax:
Practice Address - Street 1:1010 N 102ND ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2122
Practice Address - Country:US
Practice Address - Phone:619-284-4496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-138590-032163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse