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General NPI Number Information
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NPI Number | 1659932978
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Entity Type | Individual
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Provider Name | TAYLOR SAMANTHA ROBERTS AGACNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 2030 HAMILTON PLACE BLVD STE 220
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6040
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Country | US
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Telephone | 423-602-9895
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Fax | 423-553-1829
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Provider Business Mailing Address
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Address Line | 730 GERMANTOWN CIR APT 715
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City | EAST RIDGE
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State | TN
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Zip | 37412-1857
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Country | US
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Telephone | 423-653-2242
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 192284
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26189
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License Number State | TN
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