Healthcare Provider Details

I. General information

NPI: 1386370054
Provider Name (Legal Business Name): SAMANTHA JEAN CALHOUN APRN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

IV. Provider business mailing address

10 SHERIDAN PL
FAIR LAWN NJ
07410-4206
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3000
  • Fax:
Mailing address:
  • Phone: 717-799-7664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901181
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ01331300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: