Healthcare Provider Details

I. General information

NPI: 1003396367
Provider Name (Legal Business Name): SAMANTHA M HUSSNATTER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 NEXUS DR STE NWG -250
WILMINGTON DE
19803-3000
US

IV. Provider business mailing address

4000 NEXUS DR STE NWG -250
WILMINGTON DE
19803-3000
US

V. Phone/Fax

Practice location:
  • Phone: 302-320-5700
  • Fax: 302-320-5560
Mailing address:
  • Phone: 302-320-5700
  • Fax: 302-320-5560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberL1-0032506
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0001171
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: