Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | LG-0001171 | DE |
NPI | 1003396367 |
---|---|
Provider Name | Mrs. Samantha M Hussnatter |
First Address | New Castle, DE 19720-2907 |
Second Address | New Castle, DE 19720-2907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 26/05/2020 |