Provider Demographics
NPI:1821875972
Name:HILL, SAMANTHA M (FNP-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:M
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52021 CLOVERLEAF DR W
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-6034
Mailing Address - Country:US
Mailing Address - Phone:574-274-5173
Mailing Address - Fax:833-249-2411
Practice Address - Street 1:6910 N MAIN ST UNIT 52
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-8412
Practice Address - Country:US
Practice Address - Phone:574-231-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014508A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily