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Individual

SAMANTHA DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
415 CROOKED RD, DE QUEEN, AR 71832-9024
(111) 111-1111
Mailing address
415 CROOKED RD, DE QUEEN, AR 71832-9024

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10059663
OR
363LF0000X
Family Nurse Practitioner
A005362
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
223149758
AR
Enumeration date
09/21/2017
Last updated
06/01/2026
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