Provider Demographics
NPI:1114300571
Name:STOCKE, SAMANTHA JO (PA-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JO
Last Name:STOCKE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4148 FREDERICK DR
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6816
Mailing Address - Country:US
Mailing Address - Phone:724-681-4715
Mailing Address - Fax:
Practice Address - Street 1:3200 WATERFIELD DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7727
Practice Address - Country:US
Practice Address - Phone:919-800-4400
Practice Address - Fax:877-630-9339
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2022-08-23
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant