Provider Demographics
NPI:1871929018
Name:SIMPSON, CAROLYN (CNA I)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:CNA I
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:DAVIS
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA I MED TECH
Mailing Address - Street 1:1801 N TRYON ST
Mailing Address - Street 2:SUITE 305-B
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2704
Mailing Address - Country:US
Mailing Address - Phone:704-948-5654
Mailing Address - Fax:704-948-5658
Practice Address - Street 1:1801 N TRYON ST
Practice Address - Street 2:SUITE 305-B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2704
Practice Address - Country:US
Practice Address - Phone:704-948-5654
Practice Address - Fax:704-948-5658
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC227613376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide