# SAMANTHA JO SALOW

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1235808585
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1129633 | IA | — |
| 207Q00000X | Family Medicine Physician | 1129633 | WI | — |
| 363LF0000X | Family Nurse Practitioner | 11296-33 | WI | — |
| 363LP2300X | Primary Care Nurse Practitioner | A164679 | IA | Yes |

## Other

- **Enumeration date:** 09/09/2021
- **Last updated:** 07/22/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1235808585 | — | WI |