Individual
SAMANTHA ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, AGPCNP
Contact information
Practice address
1000 E CHERRY ST, TROY, MO 63379-1513
(636) 528-8551
Mailing address
1000 E CHERRY ST, TROY, MO 63379-1513
(636) 528-8551
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2021030042
MO
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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