Provider Demographics
NPI:1760733299
Name:SIMPSON, CONNIE MAE
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:MAE
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 1:226 WHALEY RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-2019
Mailing Address - Country:US
Mailing Address - Phone:740-876-1848
Mailing Address - Fax:
Practice Address - Street 1:226 WHALEY RD UNIT A
Practice Address - Street 2:
Practice Address - City:WEST PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-2019
Practice Address - Country:US
Practice Address - Phone:740-876-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide