Provider Demographics
NPI:1356104103
Name:SIMPSON MYERS, SIMONE
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:SIMPSON MYERS
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 1:5151 MONROE ST STE 210A
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3468
Mailing Address - Country:US
Mailing Address - Phone:419-265-1213
Mailing Address - Fax:
Practice Address - Street 1:5151 MONROE ST STE 210A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3468
Practice Address - Country:US
Practice Address - Phone:419-265-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1893HHN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health