Provider Demographics
NPI:1861100182
Name:KIMBROUGH, SAMANTHA NEWTON (MSN, APRN, A-GNP-C)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:NEWTON
Last Name:KIMBROUGH
Suffix:
Gender:F
Credentials:MSN, APRN, A-GNP-C
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Mailing Address - Street 1:5939 HARRY HINES BOULEVARD
Mailing Address - Street 2:PROFESSIONAL OFFICE BUILDING 2, 7TH FLOOR, SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9258
Mailing Address - Country:US
Mailing Address - Phone:214-645-1919
Mailing Address - Fax:214-645-1903
Practice Address - Street 1:5939 HARRY HINES BOULEVARD
Practice Address - Street 2:PROFESSIONAL OFFICE BUILDING 2, 7TH FLOOR, SUITE 700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9258
Practice Address - Country:US
Practice Address - Phone:214-645-1919
Practice Address - Fax:214-645-1903
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1056745363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner