| Doctor Name: | SAMANTHA G ADDISON |
| NPI Number: | 1053684332 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 0024169884 |
| Business Practice Address: | 280 Virginia Ave Ne Suite 107 Norton, VA - 242731538 |
| Business Phone Number: | 2766795390 |
| Business Fax Number: | 2766795395 |
| Mailing Address: | 999 Executive Park Blvd, Suite 201 KINGSPORT |
| State: | TN |
| Postal Code: | 376604632 |
| Phone Number: | 4232243250 |
| Fax Number: | 4232243258 |
| NPI Enumeration Date: | 02/16/2012 |
| NPI Last Update Date: | 07/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024169884 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |