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General NPI Number Information
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NPI Number | 1790580389
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Entity Type | Individual
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Provider Name | SAMANTHA RENEE SOSA WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 134 ELON RD
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City | MADISON HEIGHTS
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State | VA
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Zip | 24572-2536
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Country | US
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Telephone | 434-929-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 DUNWICH DR
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City | LIBERTY
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State | MO
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Zip | 64068-3038
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Country | US
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Telephone | 816-778-9441
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 2024040623
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024192941
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License Number State | VA
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