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General NPI Number Information
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NPI Number | 1114716628
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Entity Type | Individual
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Provider Name | CHERYL SAMUELS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1601 W SAINT MARYS RD
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City | TUCSON
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State | AZ
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Zip | 85745-2623
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Country | US
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Telephone | 520-872-1634
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Fax |
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Provider Business Mailing Address
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Address Line | 18595 S CAMINO DE LAS QUINTAS
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City | SAHUARITA
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State | AZ
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Zip | 85629-8165
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Country | US
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Telephone | 520-906-9083
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 289728
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License Number State | AZ
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