Provider Demographics
NPI:1013683010
Name:SIMPSON, MADISON ELIZABETH BURTON
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:ELIZABETH BURTON
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MADISON
Other - Middle Name:ELIZABETH
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3905 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2517
Mailing Address - Country:US
Mailing Address - Phone:919-229-4993
Mailing Address - Fax:
Practice Address - Street 1:3905 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2517
Practice Address - Country:US
Practice Address - Phone:919-229-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2205021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist