Provider Demographics
NPI:1861266215
Name:SAMSON, NANCY A (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:A
Last Name:SAMSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21281 SUMMERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8542
Mailing Address - Country:US
Mailing Address - Phone:704-728-1882
Mailing Address - Fax:
Practice Address - Street 1:19530 MT ZION PKWY
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8398
Practice Address - Country:US
Practice Address - Phone:704-997-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP2080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist