Healthcare Provider Details

I. General information

NPI: 1407535594
Provider Name (Legal Business Name): NNEKA PEARL SAMS MPH, MSN, APRN,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7035 N CHESTNUT AVE STE 103
FRESNO CA
93720-0352
US

IV. Provider business mailing address

7035 N CHESTNUT AVE STE 103
FRESNO CA
93720-0352
US

V. Phone/Fax

Practice location:
  • Phone: 559-324-0700
  • Fax: 559-324-0701
Mailing address:
  • Phone: 559-324-0700
  • Fax: 559-324-0701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95026001
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95026001
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95026001
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number95026001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: