| Doctor Name: | SAMANTHA PENDERGRASS |
| NPI Number: | 1033595806 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, FNP-C |
| License Number: | 8277949 |
| Business Practice Address: | 907 E Lamar Alexander Pkwy Maryville, TN - 378045015 |
| Business Phone Number: | 8659775795 |
| Business Fax Number: | |
| Mailing Address: | 907 E Lamar Alexander Pkwy, MARYVILLE |
| State: | TN |
| Postal Code: | 378045015 |
| Phone Number: | 8659775795 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2015 |
| NPI Last Update Date: | 08/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WX0106X |
| License Number: | 8277949 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Occupational Health |
| Taxonomy Definition: | |