Provider Demographics
NPI:1871377747
Name:HIGHTOWER, SAMANTHA ANDREA (APRN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANDREA
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 SOUTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-2644
Mailing Address - Country:US
Mailing Address - Phone:785-350-4670
Mailing Address - Fax:
Practice Address - Street 1:1169 SOUTHWIND DR
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-2644
Practice Address - Country:US
Practice Address - Phone:785-350-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82695-062363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty