Provider Demographics
NPI:1780018275
Name:SIMPSON, KIMBERLY M (CRNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:S
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 242848
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2848
Mailing Address - Country:US
Mailing Address - Phone:334-270-9914
Mailing Address - Fax:334-270-3195
Practice Address - Street 1:4258 US HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-2202
Practice Address - Country:US
Practice Address - Phone:334-874-8800
Practice Address - Fax:334-874-7700
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-088122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily