Healthcare Provider Details

I. General information

NPI: 1013784529
Provider Name (Legal Business Name): SAMANTHA MAUREEN TUCKER-CANAL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NEW WAVERLY PL
CARY NC
27518-7404
US

IV. Provider business mailing address

441 EPPS CLARK RD
SILER CITY NC
27344-9109
US

V. Phone/Fax

Practice location:
  • Phone: 919-678-6900
  • Fax: 919-678-6901
Mailing address:
  • Phone: 919-523-1120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number978
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: