| NPI | 1063758175 |
|---|---|
| Former Name | SAMANTHA DELORES BADGLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005985) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5005985) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2021-02-24 |