Provider Demographics
NPI:1366716078
Name:SIMPSON, TRACY LYNN (APRN-BC)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-262-6772
Practice Address - Fax:614-533-0162
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0243864Medicaid
FL200000005551OtherULTIMATE
FL9236918OtherCIGNA
FLY0A4QOtherBCBS
FL385808OtherAVMED
FL9646869OtherAETNA
FL015869100Medicaid
FL9236918OtherCIGNA