Samantha Leigh Clark, C-PNP
Nurse Practitioner, Pediatrics in Keizer, OR. Individual provider (NPI-1).
NPI number1841908894
StatusActive
Last updated in NPPESJul 22, 2025
Details
- NPI
- 1841908894
- Entity type
- Individual (NPI-1)
- Name
- Samantha Leigh Clark
- Credential
- C-PNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 8, 2022
- Certification date
- Jul 22, 2025
- Last updated
- Jul 22, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 10047719 | OR | Yes |
Practice location
4904 River Rd NKeizer, OR 97303-4540
Phone 503-390-2434
Mailing address
4904 River Rd NKeizer, OR 97303-4540
Phone 503-390-2434
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