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General NPI Number Information
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NPI Number | 1043406069
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Entity Type | Individual
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Provider Name | ANGELLA SAMUELS DNP
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Gender | Female
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2795 MAIN ST W BLDG 21 NEW HORIZONS FAMILY CLINIC
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City | SNELLVILLE
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State | GA
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Zip | 30078-3164
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Country | US
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Telephone | 770-248-1637
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Fax | 770-248-1638
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Provider Business Mailing Address
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Address Line | 2795 MAIN ST W BLDG 21 NEW HORIZONS FAMILY CLINIC
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City | SNELLVILLE
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State | GA
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Zip | 30078-3164
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Country | US
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Telephone | 770-248-1637
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Fax | 770-248-1638
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN133706
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License Number State | GA
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