Individual
MRS. SAMANTHA BENNETT BACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP, FNP-C
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-7100
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP015424
PA
363LF0000X
Family Nurse Practitioner
RN1015679
DC
363LF0000X
Family Nurse Practitioner
SP015424
PA
Other
Enumeration date
02/02/2012
Last updated
10/16/2020
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