| NPI | 1033595806 |
|---|---|
| Former Name | SAMANTHA RENEE PENDERGRASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20061) |
| Additional Taxonomies | 163WX0106X Registered Nurse, Occupational Health (Licence: TN 8277949) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2025-05-07 |