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General NPI Number Information
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NPI Number | 1154293561
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Entity Type | Individual
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Provider Name | SAMANTHA MICHELLE BEARDEN APRN
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1005 E LEWIS AND CLARK PKWY
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2201
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Country | US
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Telephone | 502-583-1749
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Fax |
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Provider Business Mailing Address
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Address Line | 1609 SLATE RUN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-6265
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28266547A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4046834
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License Number State | KY
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