Individual
JILL M SAMAYOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3850 PARK NICOLLET BLVD, PARK NICOLLET CLINIC SLP, ST LOUIS PARK, MN 55416-2527
(952) 993-5041
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R148078-4
MN
363L00000X
Nurse Practitioner
Primary
0851
MN
Other
Enumeration date
12/08/2005
Last updated
03/18/2021
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