Provider Demographics
NPI:1669167532
Name:MARLOW, SAMANTHA (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:
Last Name:MARLOW
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 ALCOA HWY STE 270
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1537
Mailing Address - Country:US
Mailing Address - Phone:860-304-8863
Mailing Address - Fax:
Practice Address - Street 1:1932 ALCOA HWY STE 270
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1537
Practice Address - Country:US
Practice Address - Phone:860-304-8863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000254034163W00000X
TN37377363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse