| Doctor Name: | SAMANTHA JOANNE JUSTICE |
| NPI Number: | 1013267152 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | R874488 |
| Business Practice Address: | 3114 E Shiloh Rd Corinth, MS - 388342909 |
| Business Phone Number: | 6623964406 |
| Business Fax Number: | 6623964482 |
| Mailing Address: | 3114 North Shiloh Road, Suite B CORINTH |
| State: | MS |
| Postal Code: | 38834 |
| Phone Number: | 6623964406 |
| Fax Number: | 6623964482 |
| NPI Enumeration Date: | 09/17/2012 |
| NPI Last Update Date: | 09/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R874488 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |