Individual
NICKOLAS J SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1205 RUSSELL ST, UNION CITY, TN 38261-5352
(731) 884-0002
(731) 884-1555
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA4186
TN
363AS0400X
Surgical Physician Assistant
Primary
4186
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q061558
—
MS
Enumeration date
01/07/2020
Last updated
01/23/2023
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