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NPI Code Detail

MEDICARE: MR. SAMUEL ARCHINO JR. FNP-BC

MEDICARE: MR. SAMUEL ARCHINO JR. 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
1363L00000XNurse Practitioner5020874NC
2163WE0003XEmergency Registered Nurse235585NC

General Provider Information

NPI Number : 1649005877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SAMUEL ARCHINO JR. FNP-BC
Provider Business Mailing Address
First Line : PO BOX 821
Second Line :
City : SWANSBORO
State : NC
Zip : 28584-0821
Country : US
Telephone Number : 252-702-5279
Fax Number :
Provider Business Practice Location Address
First Line : 317 WESTERN BLVD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6338
Country : US
Telephone Number : 910-577-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2024
Last Update Date : 04/17/2026

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