Individual
QUANIKA SHUNTAAYE SIMPSON-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(602) 698-8261
Mailing address
5060 N 19TH AVE STE 300-28, PHOENIX, AZ 85015-3210
(602) 698-8261
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
51627-AO-0
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8389PCS0
—
NV
Enumeration date
09/11/2018
Last updated
07/28/2020
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