Provider Demographics
NPI:1205604147
Name:SIMPSON, DJUANA MICHELE
Entity type:Individual
Prefix:MS
First Name:DJUANA
Middle Name:MICHELE
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 1:125 E 156TH ST APT 610
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-1136
Mailing Address - Country:US
Mailing Address - Phone:216-418-0869
Mailing Address - Fax:
Practice Address - Street 1:125 E 156TH ST APT 610
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1136
Practice Address - Country:US
Practice Address - Phone:216-418-0869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide