Provider Demographics
NPI:1710132709
Name:SIMPSON, REGAN MONIQUE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:REGAN
Middle Name:MONIQUE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 S EASTERN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0854
Mailing Address - Country:US
Mailing Address - Phone:216-832-7574
Mailing Address - Fax:
Practice Address - Street 1:392 E 160TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1612
Practice Address - Country:US
Practice Address - Phone:216-832-7574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLPN17070164W00000X
OHPN125254164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse