Individual
MRS. JENNIFER LEE SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CPNP
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 361-5162
(323) 361-3717
Mailing address
7975 N HAYDEN RD, STE D354, SCOTTSDALE, AZ 85258-3243
(323) 361-3550
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95075527
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95075527
STATE LICENSE
CA
Enumeration date
10/18/2007
Last updated
07/21/2022
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