Individual
SAMANTHA JO STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
701 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1070
(317) 363-1316
Mailing address
701 E COUNTY LINE RD STE 101, GREENWOOD, IN 46143-1070
(317) 885-2860
(317) 885-2869
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71014072A
IN
363LA2200X
Adult Health Nurse Practitioner
71014072A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71014072A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300080585
—
IN
Enumeration date
02/20/2023
Last updated
12/18/2024
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