Provider Demographics
NPI:1023802634
Name:ROSE, SAMANTHA MARIE PLANT (CRNP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MARIE PLANT
Last Name:ROSE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:MARIE
Other - Last Name:PLANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224 MAYO RD STE A
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2951
Mailing Address - Country:US
Mailing Address - Phone:410-956-6302
Mailing Address - Fax:
Practice Address - Street 1:224 MAYO RD STE A
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2951
Practice Address - Country:US
Practice Address - Phone:410-956-6302
Practice Address - Fax:410-956-6637
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily