Provider Demographics
NPI:1083686448
Name:SIMPSON, MARJORIE (PHD, CRNP)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PHD, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 POOLE RD STE A
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6173
Mailing Address - Country:US
Mailing Address - Phone:667-367-2260
Mailing Address - Fax:667-367-2262
Practice Address - Street 1:PO BOX 973
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-0973
Practice Address - Country:US
Practice Address - Phone:410-218-4786
Practice Address - Fax:410-795-0029
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR108131363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology