| Doctor Name: | SAMANTHA JD BAAB |
| NPI Number: | 1407177637 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | NP-982A |
| Business Practice Address: | 134 W Chubbuck Rd Chubbuck, ID - 832022315 |
| Business Phone Number: | 2082377911 |
| Business Fax Number: | 2082373450 |
| Mailing Address: | 134 W Chubbuck Rd, CHUBBUCK |
| State: | ID |
| Postal Code: | 832022315 |
| Phone Number: | 2082377911 |
| Fax Number: | 2082373450 |
| NPI Enumeration Date: | 06/22/2010 |
| NPI Last Update Date: | 12/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-982A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |