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Individual
MRS. TIFFANY SIMPSON DESIMONE
Active
Individual
MRS. TIFFANY SIMPSON DESIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
5060P
KY
363LF0000X
Family Nurse Practitioner
Primary
5060P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000501202
ANTHEM
KY
05
—
200853030
—
IN
01
—
3005060P
APRN LICENSE
KY
01
—
50015028
PASSPORT
KY
05
—
78017936
—
KY
Enumeration date
11/29/2006
Last updated
05/06/2015
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