Provider Demographics
NPI:1013356203
Name:SIMPSON, DAPHNE J (FNP)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:J
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 S HICKORY TER
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65809-1105
Mailing Address - Country:US
Mailing Address - Phone:417-350-9151
Mailing Address - Fax:
Practice Address - Street 1:761 S HICKORY TER
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65809-1105
Practice Address - Country:US
Practice Address - Phone:417-350-9151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013019749363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420007707Medicaid
MO1013356203Medicaid