Provider Demographics
NPI:1770934903
Name:LEHMAN, SAMANTHA ROSE (NP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ROSE
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SAMANTA
Other - Middle Name:ROSE
Other - Last Name:HILKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1913 LA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-4948
Mailing Address - Country:US
Mailing Address - Phone:574-529-1588
Mailing Address - Fax:574-335-0741
Practice Address - Street 1:309 INSURANCE DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-4252
Practice Address - Country:US
Practice Address - Phone:866-434-3255
Practice Address - Fax:833-673-0254
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28203792A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner