Provider Demographics
NPI:1649695404
Name:SIMPSON, DIANE (LPN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1088 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123-9598
Mailing Address - Country:US
Mailing Address - Phone:317-331-2838
Mailing Address - Fax:
Practice Address - Street 1:1088 SALEM RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-9598
Practice Address - Country:US
Practice Address - Phone:317-331-2838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153808164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse