Healthcare Provider Details

I. General information

NPI: 1831013440
Provider Name (Legal Business Name): JENNA SAMSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E 34TH ST
HIBBING MN
55746-2341
US

IV. Provider business mailing address

9285 NORWAY RIDGE RD
FORBES MN
55738-8049
US

V. Phone/Fax

Practice location:
  • Phone: 218-362-4881
  • Fax:
Mailing address:
  • Phone: 218-969-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14598
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: