Healthcare Provider Details

I. General information

NPI: 1063758175
Provider Name (Legal Business Name): SAMANTHA DELORES SCHWEITZER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA DELORES BADGLEY ARPN-BC, GNP, FNP

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 WAKE FOREST RD STE 204
RALEIGH NC
27609-7376
US

IV. Provider business mailing address

6904 N RIDGE DR
RALEIGH NC
27615-7033
US

V. Phone/Fax

Practice location:
  • Phone: 919-862-5093
  • Fax: 919-862-5605
Mailing address:
  • Phone: 304-483-3140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5005985
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5005985
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: