Provider Demographics
NPI:1336407493
Name:LILLEY, SAMANTHA GUERINGER (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:GUERINGER
Last Name:LILLEY
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA
Mailing Address - State:LA
Mailing Address - Zip Code:70647-4008
Mailing Address - Country:US
Mailing Address - Phone:337-358-2701
Mailing Address - Fax:337-358-2706
Practice Address - Street 1:621 E MILLER AVE
Practice Address - Street 2:
Practice Address - City:IOWA
Practice Address - State:LA
Practice Address - Zip Code:70647
Practice Address - Country:US
Practice Address - Phone:337-884-4890
Practice Address - Fax:337-548-9176
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP06818OtherNURSE PRACTIONER