Provider Demographics
NPI:1982351888
Name:KAKAR, SAMANTHA ALISHA (FNP-C)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ALISHA
Last Name:KAKAR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ALISHA
Other - Last Name:DOLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1811 E MCMURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5404
Mailing Address - Country:US
Mailing Address - Phone:520-374-6530
Mailing Address - Fax:520-374-6541
Practice Address - Street 1:1811 E MCMURRAY BLVD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5404
Practice Address - Country:US
Practice Address - Phone:520-374-6530
Practice Address - Fax:520-374-6541
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP267549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily