Provider Demographics
NPI:1477117182
Name:SAMSON-SMITH, KRISTI ANN (RN)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:ANN
Last Name:SAMSON-SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 CORLISS LN
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03576-3206
Mailing Address - Country:US
Mailing Address - Phone:603-237-2405
Mailing Address - Fax:
Practice Address - Street 1:141 CORLISS LN
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3206
Practice Address - Country:US
Practice Address - Phone:603-237-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH057903-21207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine