Provider Demographics
NPI:1023897626
Name:SANTY, SAMANTHA (FNP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SANTY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:TOMPKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:514 IDAHO DR
Mailing Address - Street 2:
Mailing Address - City:MEDICINE BOW
Mailing Address - State:WY
Mailing Address - Zip Code:82329-5017
Mailing Address - Country:US
Mailing Address - Phone:307-379-2222
Mailing Address - Fax:
Practice Address - Street 1:514 IDAHO DR
Practice Address - Street 2:
Practice Address - City:MEDICINE BOW
Practice Address - State:WY
Practice Address - Zip Code:82329-5017
Practice Address - Country:US
Practice Address - Phone:307-379-2222
Practice Address - Fax:307-379-2222
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF352265363LF0000X
WY55381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily