1376547901 NPI number — MRS. MICHELLE ANNE SIMPSON CRNP

Table of content: MRS. MICHELLE ANNE SIMPSON CRNP (NPI 1376547901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376547901 NPI number — MRS. MICHELLE ANNE SIMPSON CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMPSON
Provider First Name:
MICHELLE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376547901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1129 EAGLE PARK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-6940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-342-8992
Provider Business Mailing Address Fax Number:
205-383-1850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 INTERNATIONAL PARK DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35243-4217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-602-3931
Provider Business Practice Location Address Fax Number:
205-383-1850
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  1-167254 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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