Provider Demographics
NPI:1245414671
Name:SAMS, MARIAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:
Last Name:SAMS
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 1:7415 N HIGHGROVE LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-7165
Mailing Address - Country:US
Mailing Address - Phone:559-417-7618
Mailing Address - Fax:559-447-0638
Practice Address - Street 1:7035 N CHESTNUT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0352
Practice Address - Country:US
Practice Address - Phone:559-324-0700
Practice Address - Fax:559-324-0701
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily