Individual
SAMANTHA KAY NOETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMSN
Contact information
Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 877-4420
Mailing address
715 BROADWAY ST, GILLESPIE, IL 62033-1166
(217) 839-4491
(217) 839-5030
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209018361
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.018361
IL
Other
Enumeration date
10/15/2018
Last updated
10/06/2025
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