Healthcare Provider Details

I. General information

NPI: 1013839067
Provider Name (Legal Business Name): SAMANTHA MAAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4180 N THAYER RD
LIMA OH
45801-1448
US

IV. Provider business mailing address

4180 N THAYER RD
LIMA OH
45801-1448
US

V. Phone/Fax

Practice location:
  • Phone: 567-204-8484
  • Fax: 567-204-8484
Mailing address:
  • Phone: 567-204-8484
  • Fax: 567-204-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042931
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: