Provider Demographics
NPI:1063384857
Name:SIMPSON, BROOKE ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 WATERWALK CT
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8725
Mailing Address - Country:US
Mailing Address - Phone:864-909-0979
Mailing Address - Fax:
Practice Address - Street 1:817 WATERWALK CT
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8725
Practice Address - Country:US
Practice Address - Phone:864-909-0979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1502133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered