Provider Demographics
NPI:1447544481
Name:SIMPSON, SHANNON (RPH)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MARQUIS PKWY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5371
Mailing Address - Country:US
Mailing Address - Phone:757-259-3021
Mailing Address - Fax:
Practice Address - Street 1:200 MARQUIS PKWY
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5371
Practice Address - Country:US
Practice Address - Phone:757-259-3021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012504183500000X, 183500000X
KY014855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist