Individual
SAMARA A CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, NP-C
Contact information
Practice address
1550 CLINTON ST, MUSKEGON, MI 49442-5007
(231) 737-1335
Mailing address
7834 TAYLOR RIDGE DR, DELTON, MI 49046-7806
(616) 890-0087
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4704232661
MI
363LF0000X
Family Nurse Practitioner
Primary
4704232661NSA2109F
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609451905
—
MI
05
—
1629066238
—
MI
Enumeration date
04/16/2021
Last updated
01/02/2022
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