Provider Demographics
NPI:1619302577
Name:JUNIUS-ARCEMONT, SAMANTHA MARIE (FNP-BC/AG-ACNP)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:MARIE
Last Name:JUNIUS-ARCEMONT
Suffix:
Gender:F
Credentials:FNP-BC/AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3663
Mailing Address - Country:US
Mailing Address - Phone:504-228-3828
Mailing Address - Fax:
Practice Address - Street 1:1985 BARATARIA BLVD STE C
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4255
Practice Address - Country:US
Practice Address - Phone:504-766-6421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07490174H00000X, 363L00000X
LALA2037225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No174H00000XOther Service ProvidersHealth Educator
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1619302577OtherNPPES