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NPI Code Detail

MEDICARE: SAMANTHA KAY SCOGGIN MSN, RN, ACPNP

MEDICARE: SAMANTHA KAY SCOGGIN MSN, RN, ACPNP
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
1363LA2100XAcute Care Nurse Practitioner209033181IL

General Provider Information

NPI Number : 1356294086
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA KAY SCOGGIN MSN, RN, ACPNP
Provider Business Mailing Address
First Line : 2750 N SEMINARY AVE APT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7145
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 MICHIGAN ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 616-391-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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