Provider Demographics
NPI:1003331208
Name:PERSON-ALDRIDGE, SAMANTHA ELIZABETH (DNP, PMHNP-BC,FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ELIZABETH
Last Name:PERSON-ALDRIDGE
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-0363
Mailing Address - Country:US
Mailing Address - Phone:901-403-0901
Mailing Address - Fax:
Practice Address - Street 1:3173 KIRBY WHITTEN RD STE 104
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2881
Practice Address - Country:US
Practice Address - Phone:901-384-8040
Practice Address - Fax:901-888-4748
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN183218363LF0000X
TN22983363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily