Basic Information
| Provider Information | |||||||||
| NPI: | 1407417165 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | K | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1832 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667621832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202311960 | ||||||||
| FaxNumber: | 6202312808 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | ARMA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667124001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203474033 | ||||||||
| FaxNumber: | 6202315062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2019 | ||||||||
| LastUpdateDate: | 05/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 78806 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.