Provider Demographics
NPI:1437616877
Name:SIMPSON, SPARKLE S (NP-C)
Entity type:Individual
Prefix:
First Name:SPARKLE
Middle Name:S
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SUN GLOW LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2615
Mailing Address - Country:US
Mailing Address - Phone:702-487-7119
Mailing Address - Fax:702-995-0033
Practice Address - Street 1:653 N TOWN CENTER DR STE 510
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0519
Practice Address - Country:US
Practice Address - Phone:702-487-7119
Practice Address - Fax:702-995-0033
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV817373363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty