Provider Demographics
NPI:1154128189
Name:SIMPSON, DESTANY
Entity type:Individual
Prefix:
First Name:DESTANY
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3166
Mailing Address - Country:US
Mailing Address - Phone:308-340-6334
Mailing Address - Fax:
Practice Address - Street 1:1305 HIGHWAY 6 34
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NE
Practice Address - Zip Code:69022-6616
Practice Address - Country:US
Practice Address - Phone:308-697-3329
Practice Address - Fax:308-697-3278
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE145316208D00000X, 251G00000X, 251J00000X, 282E00000X, 282N00000X, 311500000X, 3747P1801X, 315D00000X, 376K00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No282E00000XHospitalsLong Term Care Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No372600000XNursing Service Related ProvidersAdult Companion