Basic Information
| Provider Information | |||||||||
| NPI: | 1205938230 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | IONA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 SALEM TURNPIKE | ||||||||
| Address2: | SUITE 8 | ||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604258701 | ||||||||
| FaxNumber: | 8604258707 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 LAFAYETTE STREET | ||||||||
| Address2: | |||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608236509 | ||||||||
| FaxNumber: | 8608892311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 044071 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.