Provider Demographics
NPI:1306691241
Name:ZAMBRANO, SAMANTHA (FNP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:ZAMBRANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LAMKIN ST APT 101
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3558
Mailing Address - Country:US
Mailing Address - Phone:719-543-6633
Mailing Address - Fax:
Practice Address - Street 1:201 LAMKIN ST APT 101
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3558
Practice Address - Country:US
Practice Address - Phone:719-543-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORXN.0109056-NP363LF0000X
CO1671547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse