| Doctor Name: | MS. ELLEN E SAMPSON |
| NPI Number: | 1023022662 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 172153 |
| Business Practice Address: | 1261 Furnace Brook Pkwy Suite 31 Quincy, MA - 02169 |
| Business Phone Number: | 6174794545 |
| Business Fax Number: | 6174794555 |
| Mailing Address: | 18 Preston Rd, WEST ROXBURY |
| State: | MA |
| Postal Code: | 021322815 |
| Phone Number: | 6173251054 |
| Fax Number: | 6174794555 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 09/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 172153 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |