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General NPI Number Information
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NPI Number | 1326600867
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Entity Type | Individual
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Provider Name | BILLY JOE SAMPSON MSN, FNP
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Gender | Male
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 8450 PARK RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-5801
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Country | US
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Telephone | 980-308-0143
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Fax | 980-308-0142
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Provider Business Mailing Address
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Address Line | PO BOX 601843
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City | CHARLOTTE
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State | NC
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Zip | 28260-1843
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F03190181
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5011923
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013840
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5011923
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License Number State | NC
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