Individual
SAMANTHA BLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
7500 W 160TH ST STE 201, STILWELL, KS 66085-8100
(913) 392-2400
Mailing address
6701 W 146TH TER APT 1101, OVERLAND PARK, KS 66223-3830
(210) 249-8199
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1193541
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
53-84261-081
KS
Other
Enumeration date
03/25/2025
Last updated
04/18/2025
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