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General NPI Number Information
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NPI Number | 1073335378
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Entity Type | Individual
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Provider Name | SAMANTHA JOLENE MCROY
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1400 S DOBSON RD
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City | MESA
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State | AZ
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Zip | 85202
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Country | US
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Telephone | 480-684-7641
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 N ALMA SCHOOL RD
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City | CHANDLER
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State | AZ
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Zip | 85224-2841
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Country | US
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Telephone |
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Fax |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN179720
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 316006
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License Number State | AZ
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