Provider Demographics
NPI:1215638705
Name:SAMENTO-YOCUM, NANCI (BSN, RN)
Entity type:Individual
Prefix:
First Name:NANCI
Middle Name:
Last Name:SAMENTO-YOCUM
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 SNAVELY RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-9068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 GIBNER RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-5090
Practice Address - Country:US
Practice Address - Phone:717-245-3879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN503067L163WP2201X, 163WC0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163W00000XNursing Service ProvidersRegistered Nurse