Individual
SAMANTHA PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(336) 406-5180
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14275612-4405
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
0001295568
VA
Other
Enumeration date
03/13/2026
Last updated
05/07/2026
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