Wilson, Samantha

Wilson, Samantha is an individual health care provider with primary practice located at 2405 W Lexington Ave , Elkhart IN 46514-1417. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wilson, Samantha can be contacted via phone (574) 295-8805.

Contact Information

Primary practice address
2405 W Lexington Ave Elkhart IN 46514-1417
Phone: (574) 295-8805
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71006376A Indiana

Profile Details

NPI number 1851743033
LBN Legal business name Wilson, Samantha
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2016
Last updated Jan 14th, 2023 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1851743033 NPPES
Indiana MEDICAID 300006929

Popular Providers