Provider Demographics
NPI:1639901796
Name:SIMPKINS, TRACEY L
Entity type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:L
Last Name:SIMPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TRACEY
Other - Middle Name:
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3730 SOUTEL DR UNIT 2306
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-1286
Mailing Address - Country:US
Mailing Address - Phone:904-657-8541
Mailing Address - Fax:
Practice Address - Street 1:3730 SOUTEL DR UNIT 2306
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-1286
Practice Address - Country:US
Practice Address - Phone:904-657-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion