Provider Demographics
NPI:1558531566
Name:ALI, SAMEERAH (FNP)
Entity type:Individual
Prefix:
First Name:SAMEERAH
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:SUZETTE
Other - Last Name:HINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6349 US HIGHWAY 550
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NM
Mailing Address - Zip Code:87013-6032
Mailing Address - Country:US
Mailing Address - Phone:575-289-3291
Mailing Address - Fax:505-443-8303
Practice Address - Street 1:6349 US HIGHWAY 550
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013-6032
Practice Address - Country:US
Practice Address - Phone:575-289-3291
Practice Address - Fax:505-443-8303
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN 138998163WS0200X
TN0000016706363LF0000X
NM59289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool