Provider Demographics
NPI:1457089120
Name:SIMPSON, MADELINE
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
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 1:6504 BOTKIN RD
Mailing Address - Street 2:
Mailing Address - City:BLUE MOUND
Mailing Address - State:KS
Mailing Address - Zip Code:66010-9418
Mailing Address - Country:US
Mailing Address - Phone:913-548-9984
Mailing Address - Fax:
Practice Address - Street 1:302 N 1ST ST
Practice Address - Street 2:
Practice Address - City:MOUND CITY
Practice Address - State:KS
Practice Address - Zip Code:66056-5279
Practice Address - Country:US
Practice Address - Phone:913-795-2203
Practice Address - Fax:913-795-8002
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-135632-051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse