Healthcare Provider Details

I. General information

NPI: 1275902900
Provider Name (Legal Business Name): SAMANTHA BELLINGER A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3366 NW EXPRESSWAY STE 660
OKLAHOMA CITY OK
73112-4416
US

IV. Provider business mailing address

2832 NW 20TH ST
OKLAHOMA CITY OK
73107-3104
US

V. Phone/Fax

Practice location:
  • Phone: 405-917-5439
  • Fax: 405-949-0849
Mailing address:
  • Phone: 405-664-6618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number102016
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number102016
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: