Individual
KELLY JO SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1122 PROFESSIONAL DR, GOSHEN, IN 46526-3819
(574) 533-0560
(574) 533-1716
Mailing address
1122 PROFESSIONAL DR, GOSHEN, IN 46526-3819
(574) 533-0560
(574) 533-1716
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71013556A
IN
363LW0102X
Women's Health Nurse Practitioner
71013556A
IN
Other
Enumeration date
01/12/2023
Last updated
04/24/2023
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