Provider Demographics
NPI:1457897076
Name:WRIGHT, SAMANTIA N (NP-C)
Entity type:Individual
Prefix:
First Name:SAMANTIA
Middle Name:N
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SAMANTIA
Other - Middle Name:N
Other - Last Name:BLACK-WRIGHT (BLACK)
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:119 STOKES ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1629
Mailing Address - Country:US
Mailing Address - Phone:732-979-9915
Mailing Address - Fax:
Practice Address - Street 1:901 W MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-252-6688
Practice Address - Fax:732-761-9705
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-07
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00698000363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health