Provider Demographics
NPI:1841854353
Name:SIMPSON, JAMIE L (PA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-2622
Mailing Address - Fax:812-471-2063
Practice Address - Street 1:2622 MENARDS DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8075
Practice Address - Country:US
Practice Address - Phone:812-450-2622
Practice Address - Fax:812-471-2063
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN10002753A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant