Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 679643 | TX |
NPI | 1083998322 |
---|---|
Provider Name | Shayla Toshika Simpson |
First Address | Cedar Hill, TX 75104-3180 |
Second Address | Dallas, TX 75235-7708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |