Provider Demographics
NPI:1619433802
Name:CASE, SAMANTHA ASHLEY (APRN)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ASHLEY
Last Name:CASE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 CLAY ST FL 1
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4507
Mailing Address - Country:US
Mailing Address - Phone:603-361-4080
Mailing Address - Fax:
Practice Address - Street 1:635 CLAY ST FL 1
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4507
Practice Address - Country:US
Practice Address - Phone:603-361-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH067887-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily