Provider Demographics
NPI:1376904409
Name:MYERS, SAMANTHA G (APRN)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:G
Last Name:MYERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:21 WHITEHALL ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867
Mailing Address - Country:US
Mailing Address - Phone:603-841-2546
Mailing Address - Fax:833-406-1471
Practice Address - Street 1:21 WHITEHALL ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867
Practice Address - Country:US
Practice Address - Phone:603-841-2546
Practice Address - Fax:833-406-1471
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH062922-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3103825Medicaid
NHT400300597Medicare PIN
NHRAILROAD P00475214Medicare PIN