SAMANTHA ROSE KHUNDMIRI RN APNP NPI 1104402361

NPI Information

NPI: 1104402361
Provider Name: SAMANTHA ROSE KHUNDMIRI, RN, APNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
6220 W LOOMIS RD
GREENDALE, WI
ZIP 53129
Phone: (414) 423-0555
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Samantha Rose Khundmiri, RN, APNP is a family nurse practitioner in Greendale, WI with 8 years of experience. Samantha Rose Khundmiri, RN, APNP NPI is 1104402361. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6220 W LOOMIS RD
GREENDALE, WI
ZIP 53129-448
Phone: (414) 423-0555

The NPI 1104402361 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/19/2021 and was last updated on 9/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	11302-33	WISCONSIN	Yes
2	163W00000X	Registered Nurse		230241-30	WISCONSIN	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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