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NPI Code Detail

MEDICARE: SAMANTHA NIELAND

MEDICARE: SAMANTHA NIELAND
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
1390200000XStudent in an Organized Health Care Education/Training ProgramIA

General Provider Information

NPI Number : 1770435273
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA NIELAND
Provider Business Mailing Address
First Line : 1611 27TH ST NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-1426
Country : US
Telephone Number : 319-310-9870
Fax Number :
Provider Business Practice Location Address
First Line : 3705 RIVER RIDGE DR NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-7596
Country : US
Telephone Number : 319-804-9321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “ SAMANTHA NIELAND ” Practice Location

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