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NPI Code Detail

MEDICARE: SAMANTHA CARRY APRN, FNP-C

MEDICARE: SAMANTHA CARRY APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner9834MN

General Provider Information

NPI Number : 1689387128
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA CARRY APRN, FNP-C
Provider Business Mailing Address
First Line : 701 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55415-1623
Country : US
Telephone Number : 612-873-3000
Fax Number :
Provider Business Practice Location Address
First Line : 101 W BURNSVILLE PKWY STE 207
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-0010
Country : US
Telephone Number : 612-548-4266
Fax Number : 952-686-6966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2022
Last Update Date : 02/20/2026

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