Individual
SAMANTHA LYNNE MASHBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-PMHNP-BC
Contact information
Practice address
1965 S FREMONT AVE STE 330, SPRINGFIELD, MO 65804-2251
(417) 820-8180
(417) 820-8261
Mailing address
1965 S FREMONT AVE STE 330, SPRINGFIELD, MO 65804-2251
(417) 820-8180
(417) 820-8261
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2017003279
MO
363LF0000X
Family Nurse Practitioner
221717
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2017003279
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
221717
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293477758
—
AR
05
—
420041045
—
MO
Enumeration date
09/14/2015
Last updated
03/09/2026
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