MEDICARE: SAMANTHA ESTELLE-ABATE MSN, APRN, FNP-BC

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	363LF0000X	Family Nurse Practitioner	2020007754	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2020007754	OTHER		ANCC

General Provider Information

NPI Number	:	1538772025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ESTELLE-ABATE MSN, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	278 ELMWOOD CIR
Second Line	:
City	:	CHESHIRE
State	:	CT
Zip	:	06410-4211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	278 ELMWOOD CIR
Second Line	:
City	:	CHESHIRE
State	:	CT
Zip	:	06410-4211
Country	:	US
Telephone Number	:	203-823-1106
Fax Number	:

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

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	08/25/2020

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