Individual
MS. LISA T. SAMANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Mailing address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.365004
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
RN1015861
DC
Other
Enumeration date
03/23/2009
Last updated
09/12/2014
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