Healthcare Provider Details

I. General information

NPI: 1710511555
Provider Name (Legal Business Name): SAMANTHA CLAIRE PHARO CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7991 BEECHMONT AVE
CINCINNATI OH
45255-3189
US

IV. Provider business mailing address

7991 BEECHMONT AVE
CINCINNATI OH
45255-3189
US

V. Phone/Fax

Practice location:
  • Phone: 513-346-3399
  • Fax: 513-346-2245
Mailing address:
  • Phone: 513-346-3399
  • Fax: 513-346-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026363
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: