Provider Demographics
NPI:1992272991
Name:SIMPSON, TORY MAGDALENE (MSN FNP-C)
Entity type:Individual
Prefix:
First Name:TORY
Middle Name:MAGDALENE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:TORY
Other - Middle Name:
Other - Last Name:COBERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 HONDO RD
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-6604
Mailing Address - Country:US
Mailing Address - Phone:817-360-5851
Mailing Address - Fax:
Practice Address - Street 1:2200 W ENNIS AVE
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-8054
Practice Address - Country:US
Practice Address - Phone:972-875-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139350363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty