Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | R108131 | MD |
NPI | 1083686448 |
---|---|
Provider Name | Dr. Marjorie Simpson |
First Address | Westminster, MD 21157-6173 |
Second Address | Westminster, MD 21158-0973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 08/10/2018 |