Healthcare Provider Details

I. General information

NPI: 1235806928
Provider Name (Legal Business Name): SAMANTHA WEBER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA SCHERMEISTER NP

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 W OKLAHOMA AVE
MILWAUKEE WI
53219-4133
US

IV. Provider business mailing address

3301 W FOREST HOME AVE
MILWAUKEE WI
53215-2843
US

V. Phone/Fax

Practice location:
  • Phone: 414-546-2992
  • Fax: 414-546-2996
Mailing address:
  • Phone: 414-546-2992
  • Fax: 414-546-2996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11181
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11181
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: