Provider Demographics
NPI:1760727606
Name:HALIT, SAMANTHA SYLVIA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SYLVIA
Last Name:HALIT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3695 LINDEN AVE
Mailing Address - Street 2:UNIT 7A
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4021
Mailing Address - Country:US
Mailing Address - Phone:310-729-1821
Mailing Address - Fax:
Practice Address - Street 1:3695 LINDEN AVE
Practice Address - Street 2:UNIT 7A
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4021
Practice Address - Country:US
Practice Address - Phone:310-729-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily