Individual
MS. POLINA MOISEYEVNA SAMOYLOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 W MAGEE RD, TUCSON, AZ 85704-6438
(520) 638-5553
(520) 638-5543
Mailing address
400 W MAGEE RD, TUCSON, AZ 85704-5555
(520) 638-5553
(520) 638-5543
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP11404
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295211159
—
AZ
01
—
AP11404
ARIZONA STATE BOARD OF NURSING
AZ
01
—
F06182317
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
AZ
Enumeration date
07/13/2018
Last updated
09/19/2018
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