Healthcare Provider Details

I. General information

NPI: 1386556264
Provider Name (Legal Business Name): SAMANTHA ROSE MERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 DOWNS RD
WESTFORD MA
01886-1009
US

IV. Provider business mailing address

7 DOWNS RD
WESTFORD MA
01886-1009
US

V. Phone/Fax

Practice location:
  • Phone: 978-727-3678
  • Fax:
Mailing address:
  • Phone: 978-727-3678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2368124
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: