Individual
MRS. SAMANTHA LORRAINE KIRK JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
251 NAJOLES RD, MILLERSVILLE, MD 21108-2519
(410) 729-0690
Mailing address
7917 W RIVERSIDE DR, PASADENA, MD 21122-3825
(301) 219-7477
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R228455
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197364900
—
MD
Enumeration date
11/23/2024
Last updated
02/04/2025
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