Individual
SAMANTHA RAE WHEELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1500 BROAD ST, MONTOURSVILLE, PA 17754-8300
(570) 368-2801
(570) 368-0609
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN595800
PA
363L00000X
Nurse Practitioner
Primary
SP014019
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102986964
—
PA
01
—
2P3689
MEDICARE
PA
Enumeration date
07/15/2014
Last updated
04/04/2023
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