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Individual

SAMANTHA NOWAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4435 RONALD REAGAN BLVD, JOHNSTOWN, CO 80534-6566
(970) 619-8139
Mailing address
4435 RONALD REAGAN BLVD, JOHNSTOWN, CO 80534-6566

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6653
GA
363A00000X
Physician Assistant
Primary
8956
CO

Other

Enumeration date
11/07/2012
Last updated
05/23/2025
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