Healthcare Provider Details

I. General information

NPI: 1942160601
Provider Name (Legal Business Name): SAMANTHA HERSHON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 JEFFERSON ST APT 305
ALEXANDRIA VA
22314-4374
US

IV. Provider business mailing address

605 JEFFERSON ST APT 305
ALEXANDRIA VA
22314-4374
US

V. Phone/Fax

Practice location:
  • Phone: 571-455-0430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number500125508
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number0001316057
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0001316057
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: