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Individual

MS. ELLEN E SAMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1261 FURNACE BROOK PKWY, SUITE 31, QUINCY, MA 02169
(617) 479-4545
(617) 479-4555
Mailing address
18 PRESTON RD, WEST ROXBURY, MA 02132-2815
(617) 325-1054
(617) 479-4555

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
172153
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0708020
MA
Enumeration date
07/28/2006
Last updated
09/26/2009
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