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General NPI Number Information
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NPI Number | 1518769058
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Entity Type | Individual
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Provider Name | SAMANTHA BLY PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 7500 W 160TH ST STE 201
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City | STILWELL
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State | KS
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Zip | 66085-8100
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Country | US
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Telephone | 913-392-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 W 146TH TER APT 1101
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City | OVERLAND PARK
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State | KS
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Zip | 66223-3830
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Country | US
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Telephone | 210-249-8199
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1193541
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-84261-081
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License Number State | KS
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