Provider Demographics
NPI:1386504777
Name:SIMPSON, NADINE ILANA (CRNP, DNP)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:ILANA
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:CRNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3642 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2401
Mailing Address - Country:US
Mailing Address - Phone:201-220-5521
Mailing Address - Fax:
Practice Address - Street 1:3642 ELM AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2401
Practice Address - Country:US
Practice Address - Phone:201-220-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR202348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine