Robertson, Samantha

Robertson, Samantha is an individual health care provider with primary practice located at 2183 W Main St , Lehi UT 84043-6760. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Robertson, Samantha can be contacted via phone (385) 203-1215.

Contact Information

Primary practice address
2183 W Main St Lehi UT 84043-6760
Phone: (385) 203-1215
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60739580 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110005133 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 12196775-1206 Utah

Profile Details

NPI number 1962876516
LBN Legal business name Robertson, Samantha
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2015
Last updated Dec 17th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962876516 NPPES
Washington MEDICAID 2086587

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