MEDICARE: SAMANTHA LYNN DORCEY

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	363L00000X	Nurse Practitioner	116547	NE

General Provider Information

NPI Number	:	1962366039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA LYNN DORCEY

Provider Business Mailing Address
First Line	:	3140 E ELK LN STE 600
Second Line	:
City	:	FREMONT
State	:	NE
Zip	:	68025-8650
Country	:	US
Telephone Number	:	402-936-6198
Fax Number	:	402-816-4402

Provider Business Practice Location Address
First Line	:	120 W 2ND ST STE 1
Second Line	:
City	:	WAYNE
State	:	NE
Zip	:	68787-1957
Country	:	US
Telephone Number	:	531-519-6074
Fax Number	:	531-519-6858

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ SAMANTHA LYNN DORCEY ” Practice Location

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