Individual
SAMANTHA GOUTERMOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
522 S 4TH ST, FULTON, NY 13069-2946
(315) 592-3930
(315) 592-3932
Mailing address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
(315) 349-5921
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
717095
NY
Other
Enumeration date
06/13/2022
Last updated
03/29/2023
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