Provider Demographics
NPI:1598411860
Name:ISABELLA, SAMANTHA CAPRI (PA-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CAPRI
Last Name:ISABELLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 22ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5473
Mailing Address - Country:US
Mailing Address - Phone:239-285-6706
Mailing Address - Fax:
Practice Address - Street 1:543 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3337
Practice Address - Country:US
Practice Address - Phone:207-922-1300
Practice Address - Fax:207-217-6742
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA2322207P00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine