Healthcare Provider Details

I. General information

NPI: 1912874769
Provider Name (Legal Business Name): SAMANTHA LAFFEY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1612
VINEYARD HAVEN MA
02568-0908
US

IV. Provider business mailing address

PO BOX 1612
VINEYARD HAVEN MA
02568-0908
US

V. Phone/Fax

Practice location:
  • Phone: 508-299-9489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2366506
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: