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General NPI Number Information
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NPI Number | 1437694726
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Entity Type | Individual
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Provider Name | SAMANTHA N NESBETH APRN, AGPCNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 06/01/2025
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Provider Practice Location Address
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Address Line | 963 QUEEN ST STE E
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City | SOUTHINGTON
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State | CT
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Zip | 06489-1282
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Country | US
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Telephone | 860-839-6013
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Fax |
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Provider Business Mailing Address
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Address Line | 148 ELMWOOD DR
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City | MERIDEN
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State | CT
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Zip | 06450-7311
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Country | US
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Telephone | 203-623-2592
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 6892
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License Number State | CT
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