Most Relevant Information
Provider Data
| NPI Number: | 1003636879 |
| Provider Name: | SAMANTHA MCMAHON FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 15916-33 |
Most Important Dates
| Enumeration Date: | 10/15/2024 |
| Last Updated: | 10/15/2024 |
Provider Practice Location
2845 GREENBRIER RD STE 310
GREEN BAY
WI
543116519
Practice Location Phone/Fax
| Phone: | 9202888300 |
| Fax: |
Provider Mailing Location
2861 FLOWERING PEACH DR
SUAMICO
WI
543133230
Provider Mailing Phone/Fax
| Phone: | 4143318741 |
| Fax: |