Provider Demographics
NPI:1861430084
Name:SIMPSON, BETSY JOHNSTON (PT)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:JOHNSTON
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 CROSBY DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3313
Mailing Address - Country:US
Mailing Address - Phone:336-228-8020
Mailing Address - Fax:336-228-8020
Practice Address - Street 1:2111 CROSBY DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3313
Practice Address - Country:US
Practice Address - Phone:336-228-8020
Practice Address - Fax:336-228-8020
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC479225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211524Medicaid
NC079HKOtherBCBS