Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 7306-33 | WI |
NPI | 1003365008 |
---|---|
Provider Name | Brittany Simpson |
First Address | Monroe, WI 53566-1569 |
Second Address | Monroe, WI 53566-1569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2016 |
Last Update Date | 18/11/2016 |