Individual
MRS. SAMARA LYSE BEATRICE CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3228 N. 20TH STREET, PHILADELPHIA, PA 19140
(267) 880-8118
Mailing address
3228 N 20TH STREET, PHILADELPHIA, PA 19140
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
L8--0010993
DE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP034244
PA
Other
Enumeration date
10/23/2025
Last updated
05/01/2026
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