Provider Demographics
NPI:1841740826
Name:SIMPLICE, GERALDINE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:
Last Name:SIMPLICE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HICKORY WAY
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-1307
Mailing Address - Country:US
Mailing Address - Phone:203-613-5834
Mailing Address - Fax:
Practice Address - Street 1:120 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-1525
Practice Address - Country:US
Practice Address - Phone:203-899-1770
Practice Address - Fax:203-852-3989
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6779363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care