=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447650619
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAMANTHA MARIE PIERCE CNM, WHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2014
-----------------------------------------------------
Last Update Date | 08/22/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 575 HILL COUNTRY DR
-----------------------------------------------------
City | KERRVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-258-6237
-----------------------------------------------------
Fax | 830-315-1366
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 575 HILL COUNTRY DR
-----------------------------------------------------
City | KERRVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78028-6024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-258-6237
-----------------------------------------------------
Fax | 830-315-1366
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | AP126215
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | AP126215
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------