Provider Demographics
NPI:1710627328
Name:GILCREASE, SAMANTHA CLAWSON (FNP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CLAWSON
Last Name:GILCREASE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W TAMPICO ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-1305
Mailing Address - Country:US
Mailing Address - Phone:337-384-3575
Mailing Address - Fax:
Practice Address - Street 1:1322 ELTON RD STE P
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4100
Practice Address - Country:US
Practice Address - Phone:378-242-2823
Practice Address - Fax:337-824-0058
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA224385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily