Individual
MS. SAMANTHA MARIE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, RNFA
Contact information
Practice address
620 ERIE BLVD W, SYRACUSE, NY 13204-2445
(315) 472-7363
(315) 472-0084
Mailing address
620 ERIE BLVD W STE 302, SYRACUSE, NY 13204-2463
(315) 472-7363
(315) 472-0084
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
532811
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405062-01
NY
Other
Enumeration date
09/07/2018
Last updated
01/01/2025
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