Provider Demographics
NPI:1992241384
Name:SAMPLES, LINDSAY (NP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SAMPLES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9131 RAINBOW LN
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-5159
Mailing Address - Country:US
Mailing Address - Phone:810-434-5054
Mailing Address - Fax:
Practice Address - Street 1:9131 RAINBOW LN
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-5159
Practice Address - Country:US
Practice Address - Phone:810-434-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9296791363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health