Healthcare Provider Details

I. General information

NPI: 1659295897
Provider Name (Legal Business Name): SAMANTHA CORSO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA STROHM

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 BELK BLVD
OXFORD MS
38655-1992
US

IV. Provider business mailing address

735 BELK BLVD
OXFORD MS
38655-1992
US

V. Phone/Fax

Practice location:
  • Phone: 662-513-2000
  • Fax: 662-513-2001
Mailing address:
  • Phone: 662-513-2000
  • Fax: 662-513-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908676
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: