Individual
SAMANTHA ROESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
100 E LANCASTER AVE, THE HEART PAVILION, MEZZANINE LEVEL, WYNNEWOOD, PA 19096-3450
(484) 476-1000
(484) 476-9000
Mailing address
100 E LANCASTER AVE, THE HEART PAVILION, MEZZANINE LEVEL, WYNNEWOOD, PA 19096-3450
(484) 476-1000
(484) 476-9000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP009229
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-2359401
MLHC TAX ID
PA
Enumeration date
04/22/2008
Last updated
06/23/2015
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