Provider Demographics
NPI:1336480466
Name:STOLL, SAMANTHA BRITTANY (RN, NP, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BRITTANY
Last Name:STOLL
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Gender:F
Credentials:RN, NP, WHNP-BC
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Mailing Address - Street 1:1300 N VERMONT AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6005
Mailing Address - Country:US
Mailing Address - Phone:323-953-8821
Mailing Address - Fax:323-953-9503
Practice Address - Street 1:1300 N VERMONT AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6005
Practice Address - Country:US
Practice Address - Phone:323-953-8821
Practice Address - Fax:323-953-9503
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA826261163W00000X
CA22636363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse