Provider Demographics
NPI:1750963393
Name:SIMPSON, CAJUAN MICHELE (LVN)
Entity type:Individual
Prefix:
First Name:CAJUAN
Middle Name:MICHELE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10228 E NORTHWEST HWY # 1033
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-4408
Mailing Address - Country:US
Mailing Address - Phone:214-614-8408
Mailing Address - Fax:
Practice Address - Street 1:10228 E NORTHWEST HWY # 1033
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-4408
Practice Address - Country:US
Practice Address - Phone:214-614-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX182713164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse