Individual
SAMANTHA NICOLE GLENN ETHEREDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 DENNY AVE STE 240, PASCAGOULA, MS 39581-5307
(228) 872-1951
(228) 875-9998
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35673
MS
207QS0010X
Sports Medicine (Family Medicine) Physician
3818
AL
Other
Enumeration date
03/29/2021
Last updated
09/24/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us