Provider Demographics
NPI:1093306342
Name:LOCHRIDGE, SAMANTHA (APN)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LOCHRIDGE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-1656
Mailing Address - Country:US
Mailing Address - Phone:731-779-9395
Mailing Address - Fax:731-779-9397
Practice Address - Street 1:1203 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-1656
Practice Address - Country:US
Practice Address - Phone:731-779-9395
Practice Address - Fax:731-779-9397
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28942363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner