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General NPI Number Information
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NPI Number | 1376338574
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Entity Type | Individual
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Provider Name | SAMANTHA NIVENS APRN
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 102 S MAIN ST
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City | SAND SPRINGS
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State | OK
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Zip | 74063-6509
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Country | US
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Telephone | 228-691-8245
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 S YALE AVE STE 1400
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City | TULSA
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State | OK
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Zip | 74136-3331
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Country | US
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Telephone | 918-499-4855
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Fax | 918-488-6098
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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 | 00000000
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License Number State | OK
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