Healthcare Provider Details

I. General information

NPI: 1548174576
Provider Name (Legal Business Name): SAMANTHA KREMER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7033 LESTA CT
INDIANAPOLIS IN
46217-8411
US

IV. Provider business mailing address

7033 LESTA CT
INDIANAPOLIS IN
46217-8411
US

V. Phone/Fax

Practice location:
  • Phone: 317-412-3051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF04260298
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: