Provider Demographics
NPI:1942996657
Name:SIMPSON, TRENAE
Entity Type:Individual
Prefix:
First Name:TRENAE
Middle Name:
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 1:1703 BENDER RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-8008
Mailing Address - Country:US
Mailing Address - Phone:901-627-3277
Mailing Address - Fax:901-587-5079
Practice Address - Street 1:1703 BENDER RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-8008
Practice Address - Country:US
Practice Address - Phone:901-627-3277
Practice Address - Fax:901-587-5079
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN246RP1900X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy