Samson, Mary Andelle

Samson, Mary Andelle is an individual health care provider with primary practice located at 21 Grand St , Hartford CT 06106-1541. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Samson, Mary Andelle can be contacted via phone (860) 550-7500.

Contact Information

Primary practice address
21 Grand St Hartford CT 06106-1541
Phone: (860) 550-7500
Fax: (860) 241-0890
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 3516 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 3516 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R173837 Maryland

Profile Details

NPI number 1801001128
LBN Legal business name Samson, Mary Andelle
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2007
Last updated Sep 29th, 2022 - about 4 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 1801001128 NPPES
Connecticut MEDICAID 013358200

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