Provider Demographics
NPI:1740989227
Name:SIMPSON, SHONTE R
Entity type:Individual
Prefix:
First Name:SHONTE
Middle Name:R
Last Name:SIMPSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 S EASTERN AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3926
Mailing Address - Country:US
Mailing Address - Phone:702-677-3086
Mailing Address - Fax:
Practice Address - Street 1:10120 S EASTERN AVE STE 207
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3926
Practice Address - Country:US
Practice Address - Phone:702-677-3086
Practice Address - Fax:800-606-7190
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide