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NPI Code Detail

MEDICARE: SAMANTHA ASHCROFT

MEDICARE:   SAMANTHA  ASHCROFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistNM

General Provider Information

NPI Number : 1154942746
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA ASHCROFT
Provider Business Mailing Address
First Line : 2801 MISSOURI AVE STE 22
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5062
Country : US
Telephone Number : 575-915-1338
Fax Number : 575-915-1819
Provider Business Practice Location Address
First Line : 2801 MISSOURI AVE STE 22
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5062
Country : US
Telephone Number : 575-915-1338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2020
Last Update Date : 05/05/2020

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Directions to “ SAMANTHA ASHCROFT ” Practice Location

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