Provider Demographics
NPI:1346726874
Name:EAKER, SAMANTHA RUSSOMAGNO (DNP, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:RUSSOMAGNO
Last Name:EAKER
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:40 MEDICAL CIRCLE DUKE SOUTH WHITE ZONE ROOM 1572
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-6994
Mailing Address - Fax:
Practice Address - Street 1:DUKE UNIVERSITY HOSPITAL 2301 ERWIN ROAD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-6994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5010688363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics