Provider Demographics
NPI:1912645573
Name:DMOCHOWSKI, SAMANTHA MEGHAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:MEGHAN
Last Name:DMOCHOWSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9511 TIMBERLOG DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4630
Mailing Address - Country:US
Mailing Address - Phone:423-838-5676
Mailing Address - Fax:
Practice Address - Street 1:979 E 3RD ST STE C620
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3333
Practice Address - Country:US
Practice Address - Phone:423-778-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30351363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care