=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831013440
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNA SAMSA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2026
-----------------------------------------------------
Last Update Date | 08/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 750 E 34TH ST
-----------------------------------------------------
City | HIBBING
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55746-2341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-362-4881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9285 NORWAY RIDGE RD
-----------------------------------------------------
City | FORBES
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55738-8049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-969-2650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 14598
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------