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General NPI Number Information
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NPI Number | 1366325524
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Entity Type | Individual
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Provider Name | MRS. SAMANTHA WILTZ
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1700 WHEELING ST
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City | AURORA
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State | CO
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Zip | 80045-7211
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Country | US
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Telephone | 720-329-7347
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Fax |
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Provider Business Mailing Address
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Address Line | 17576 CABIN HILL LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-1466
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Country | US
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Telephone | 719-352-6036
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 0168150
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License Number State | CO
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