Healthcare Provider Details

I. General information

NPI: 1366363251
Provider Name (Legal Business Name): SAMANTHA ASHLEY YORK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31340 SOLON RD STE 27
SOLON OH
44139-3574
US

IV. Provider business mailing address

7145 MAPLE ST
MENTOR OH
44060-4914
US

V. Phone/Fax

Practice location:
  • Phone: 440-919-0180
  • Fax: 440-919-0180
Mailing address:
  • Phone: 440-919-0180
  • Fax: 440-919-0181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026042711
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: