MEDICARE: SAMANTHA UWHUBETIYI RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN710069	GA

General Provider Information

NPI Number	:	1447588694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA UWHUBETIYI RN

Provider Business Mailing Address
First Line	:	8 MILLIE LN
Second Line	:
City	:	PORT WENTWORTH
State	:	GA
Zip	:	31407-5608
Country	:	US
Telephone Number	:	516-424-8855
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 MILLIE LN
Second Line	:
City	:	PORT WENTWORTH
State	:	GA
Zip	:	31407-5608
Country	:	US
Telephone Number	:	516-424-8855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2009
Last Update Date	:	01/20/2026

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