Provider Demographics
NPI:1295806701
Name:SIMPSON, JILL EILEEN (FNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:EILEEN
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 1:1202 JOANIES CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8844
Mailing Address - Country:US
Mailing Address - Phone:803-980-5515
Mailing Address - Fax:
Practice Address - Street 1:WINTHROP UNIVERSITY HEALTH
Practice Address - Street 2:708 OAKLAND AVE. CRAWFORD BLDG.
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29733-0001
Practice Address - Country:US
Practice Address - Phone:803-323-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN1632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCJ2643365OtherMEDICARE PIN
SCSCJ2645019OtherMEDICARE PIN
SCNP0588Medicaid