Provider Demographics
NPI:1093280174
Name:CASPER, SAMANTHA (NP-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CASPER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 WINDBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:GRIMESLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27837-9126
Mailing Address - Country:US
Mailing Address - Phone:252-341-9893
Mailing Address - Fax:
Practice Address - Street 1:2645 MERIDIAN PKWY STE 323
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4232
Practice Address - Country:US
Practice Address - Phone:984-227-8902
Practice Address - Fax:844-813-6747
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011074363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner