Provider Demographics
NPI:1548911605
Name:DAVIS, SAMANTHA L (DNP)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:L
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:KS
Mailing Address - Zip Code:66401-8785
Mailing Address - Country:US
Mailing Address - Phone:785-294-1723
Mailing Address - Fax:
Practice Address - Street 1:8301 POSITANO DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4861
Practice Address - Country:US
Practice Address - Phone:785-587-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80810-021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine