Individual
MEGHAN SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(888) 720-2012
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9982
WI
363LF0000X
Family Nurse Practitioner
71010661A
IN
363LF0000X
Family Nurse Practitioner
9982-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100257656
—
WI
05
—
300046042
—
IN
Enumeration date
07/03/2020
Last updated
01/25/2024
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