Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | F01201674 | AZ |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 238292 | AZ |
NPI | 1245867589 |
---|---|
Provider Name | Samantha Jordan Ramsay |
First Address | Phoenix, AZ 85014-5698 |
Second Address | Phoenix, AZ 85014-5698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2020 |
Last Update Date | 28/12/2021 |