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General NPI Number Information
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NPI Number | 1760366603
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Entity Type | Individual
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Provider Name | SAMANTHA ROCHE FNP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 300 W 1400 S
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City | GARLAND
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State | UT
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Zip | 84312-9100
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Country | US
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Telephone | 435-257-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 10990 W 9600 N
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City | TREMONTON
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State | UT
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Zip | 84337-9213
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Country | US
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Telephone | 208-240-4590
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | TBD
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License Number State | UT
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