Provider Demographics
NPI:1720201403
Name:SIMPSON, JAUNITA MARIE
Entity Type:Individual
Prefix:
First Name:JAUNITA
Middle Name:MARIE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 69Z
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:OK
Mailing Address - Zip Code:73548-9502
Mailing Address - Country:US
Mailing Address - Phone:580-583-1242
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 69Z
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:OK
Practice Address - Zip Code:73548-9502
Practice Address - Country:US
Practice Address - Phone:580-583-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care