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NPI Code Detail

MEDICARE: SAMANTHA REIS

MEDICARE: SAMANTHA REIS
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
1363LP0200XPediatric Nurse PractitionerRN255532GA

General Provider Information

NPI Number : 1467169623
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA REIS
Provider Business Mailing Address
First Line : PO BOX 13289
Second Line :
City : DURHAM
State : NC
Zip : 27709-3289
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 41 PERIMETER CTR E STE 640
Second Line :
City : DUNWOODY
State : GA
Zip : 30346-1903
Country : US
Telephone Number : 770-871-3730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2022
Last Update Date : 10/27/2022

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Directions to “ SAMANTHA REIS ” Practice Location

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