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Individual

SAMANTHA LYNN MUSSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 750-7445
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 750-7379

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
58914
ID
207Q00000X
Family Medicine Physician
58914
ID
363LF0000X
Family Nurse Practitioner
Primary
58914
ID

Other

Enumeration date
06/18/2018
Last updated
07/24/2020
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