SAMANTHA LYNNE WYLIE NP NPI 1962954354

NPI Information

NPI: 1962954354
Provider Name: SAMANTHA LYNNE WYLIE, NP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
35 MICHIGAN ST NE STE 3003
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 267-2570
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Samantha Lynne Wylie, NP is a primary care nurse practitioner in Grand Rapids, MI. Samantha Lynne Wylie, NP NPI is 1962954354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

35 MICHIGAN ST NE STE 3003
GRAND RAPIDS, MI
ZIP 49503-528
Phone: (616) 267-2570

The NPI 1962954354 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2016 and was last updated on 2/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	4704265506	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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