NELLIE IDARA SAMUEL MSN APRNPMHNP-BC NPI 1821344557

NPI Information

NPI: 1821344557
Provider Name: NELLIE IDARA SAMUEL, MSN, APRN,PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
2400 NORTHSIDE XING
MACON, GA
ZIP 31210
Phone: (865) 765-8225
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Nellie Idara Samuel, MSN, APRN,PMHNP-BC is a psychiatric/mental health nurse practitioner in Macon, GA with 9 years of experience. Nellie Idara Samuel, MSN, APRN,PMHNP-BC NPI is 1821344557. 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:

2400 NORTHSIDE XING
MACON, GA
ZIP 31210-252
Phone: (865) 765-8225

The NPI 1821344557 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 7/31/2012 and was last updated on 12/28/2020.

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	163WP0807X	Registered Nurse	Psychiatric/Mental Health, Child & Adolescent	RN225022	GEORGIA	No
2	163WP0808X	Registered Nurse	Psychiatric/Mental Health	RN225022	GEORGIA	No
3	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	RN225022	GEORGIA	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP10318	ARIZONA	No
5	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	95014791	CALIFORNIA	No
6	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	RN225022	GEORGIA	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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