| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SAMANTHA GRIDER | 1013303569 | 2024-09-06 |
Samantha C Grider [F] graduated in 2015 and primarily specializes in Nurse Practitioner.
Samantha Grider is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1013303569. Registration indicates Samantha Grider is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 6709194475 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Samantha Grider |
| Practice Office Address | 2325 18TH ST STE 220 COLUMBUS, IN US |
| Practice Office Telephone | 8123765640 |
| Mailing Address | PO BOX 775383 CHICAGO, IL 606775383 US |
| Business Telephone | 8123765315 |
| Direct address [Direct address] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 28198183A
IN |