Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 22003 | CA |
NPI | 1063857498 |
---|---|
Provider Name | Allyn Ann Simpson |
First Address | Newport Beach, CA 92660-7720 |
Second Address | Newport Beach, CA 92660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2013 |
Last Update Date | 15/01/2014 |