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General NPI Number Information
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NPI Number | 1962038570
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Entity Type | Individual
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Provider Name | SAMANTHA MONTGOMERY WARREN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/15/2020
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 328 CUMMINGS ST STE A
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City | ABINGDON
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State | VA
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Zip | 24210-3245
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Country | US
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Telephone | 276-451-2099
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Fax | 833-635-6919
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Provider Business Mailing Address
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Address Line | 23447 SHELL RD
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City | ABINGDON
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State | VA
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Zip | 24211-5373
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Country | US
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Telephone | 276-608-5800
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Fax | 833-635-6919
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024178134
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License Number State | VA
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