Provider Demographics
NPI:1336885839
Name:SAGER, SAMANTHA JOANN (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JOANN
Last Name:SAGER
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:JOANN
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34499 JACOB RD
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-9051
Mailing Address - Country:US
Mailing Address - Phone:918-839-2282
Mailing Address - Fax:
Practice Address - Street 1:1500 DODSON AVE STE 230
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5179
Practice Address - Country:US
Practice Address - Phone:479-709-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-08
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207817363LF0000X
AR219566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily