Provider Demographics
NPI:1689276503
Name:SIMPKINS, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SIMPKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3777 EDENDALE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4120
Mailing Address - Country:US
Mailing Address - Phone:614-571-2956
Mailing Address - Fax:
Practice Address - Street 1:3777 EDENDALE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-4120
Practice Address - Country:US
Practice Address - Phone:614-571-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2547980Medicaid