Individual
ATHENA THEODORA SAMARAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPCNP-BC
Contact information
Practice address
1046 E WENDOVER AVE, GREENSBORO, NC 27405-6712
(336) 272-1050
Mailing address
1046 E WENDOVER AVE, GREENSBORO, NC 27405-6712
(336) 272-1050
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5008790
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008790
NC APPROVAL TO PRACTICE
NC
Enumeration date
08/11/2016
Last updated
08/11/2016
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