Provider Demographics
NPI:1003356767
Name:CRISTE, SAMANTHA JOANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:JOANNE
Last Name:CRISTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 JENKINS RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28526-9399
Mailing Address - Country:US
Mailing Address - Phone:252-933-6698
Mailing Address - Fax:855-236-3085
Practice Address - Street 1:235 JENKINS RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NC
Practice Address - Zip Code:28526-9399
Practice Address - Country:US
Practice Address - Phone:252-933-6698
Practice Address - Fax:855-236-3085
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009331363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner