Healthcare Provider Details

I. General information

NPI: 1770435273
Provider Name (Legal Business Name): SAMANTHA NIELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA UHLENKAMP

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 RIVER RIDGE DR NE
CEDAR RAPIDS IA
52402-7596
US

IV. Provider business mailing address

1611 27TH ST NW
CEDAR RAPIDS IA
52405-1426
US

V. Phone/Fax

Practice location:
  • Phone: 319-804-9321
  • Fax:
Mailing address:
  • Phone: 319-310-9870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA190463
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: