Provider Demographics
NPI:1548806383
Name:SAMPSON, DONNA GERALDINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:GERALDINE
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 GLENLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-5730
Mailing Address - Country:US
Mailing Address - Phone:850-212-1465
Mailing Address - Fax:
Practice Address - Street 1:1403 GLENLEIGH DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-5730
Practice Address - Country:US
Practice Address - Phone:850-212-1465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004813163WH0500X, 163WN0300X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WN0300XNursing Service ProvidersRegistered NurseNephrology