Provider Demographics
NPI:1811688120
Name:SKINNER, SAMANTHA (DNP, FNP, APN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:DNP, FNP, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3746
Mailing Address - Country:US
Mailing Address - Phone:609-335-9580
Mailing Address - Fax:
Practice Address - Street 1:1301 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-7247
Practice Address - Country:US
Practice Address - Phone:609-572-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15559000163W00000X
NJ26NJ14925300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse