SAM KIDANE NPI 1497412399

NPI Information

  • NPI: 1497412399
  • Provider Name: SAM KIDANE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 314 E MAIN ST STE 103
    NEWARK, DE
    ZIP 19711
  • Phone: (302) 366-0550

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NPI Details

Sam Kidane is a family nurse practitioner in Newark, DE with 5 years of experience. Sam Kidane NPI is 1497412399. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

314 E MAIN ST STE 103
NEWARK, DE
ZIP 19711-180
Phone: (302) 366-0550

The NPI 1497412399 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 11/26/2021 and was last updated on 5/14/2024.

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
1363LF0000XNurse PractitionerFamily0024188207VIRGINIANo
2363LF0000XNurse PractitionerFamilyLG-0011831DELAWAREYes

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: 11/21/2025

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