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NPI Code Detail

MEDICARE: MRS. SAMANTHA CASTEEL APRN

MEDICARE: MRS. SAMANTHA CASTEEL APRN
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 Practitioner2024009045MO

General Provider Information

NPI Number : 1871345637
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SAMANTHA CASTEEL APRN
Provider Business Mailing Address
First Line : 1624 SOUTHWEST BLVD
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-2434
Country : US
Telephone Number : 573-821-3032
Fax Number :
Provider Business Practice Location Address
First Line : 107 W ELDON ST
Second Line :
City : SAINT JAMES
State : MO
Zip : 65559-1903
Country : US
Telephone Number : 573-265-1818
Fax Number : 573-265-1810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2024
Last Update Date : 04/04/2024

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