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NPI Code Detail

MEDICARE: SAMANTHA SMITH

MEDICARE:   SAMANTHA  SMITH
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
1363LF0000XFamily Nurse Practitioner0024180780VA
2363LF0000XFamily Nurse Practitioner29078TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001259809OTHERVAREGISTERED NURSING LICENSURE

General Provider Information

NPI Number : 1831717008
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA SMITH
Provider Business Mailing Address
First Line : 4428 DR THOMAS WALKER RD
Second Line :
City : ROSE HILL
State : VA
Zip : 24281-8382
Country : US
Telephone Number : 276-244-2157
Fax Number :
Provider Business Practice Location Address
First Line : 4428 DR THOMAS WALKER RD
Second Line :
City : ROSE HILL
State : VA
Zip : 24281-8382
Country : US
Telephone Number : 276-244-2157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2020
Last Update Date : 04/08/2022

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Directions to “ SAMANTHA SMITH ” Practice Location

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