Individual
MRS. SAMANTHA ANNE MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, AGACNP-BC
Contact information
Practice address
740 S LIMESTONE L543 KY CLINIC, LEXINGTON, KY 40536-0284
(270) 792-8157
Mailing address
800 ROSE ST, LEXINGTON, KY 40536-7001
(270) 792-8157
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3011114
KY
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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