| NPI | 1639876519 |
|---|---|
| Former Name | SAMANTHA MALONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4000479) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030543) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-03-22 |