Basic Information
| Provider Information | |||||||||
| NPI: | 1134746597 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BORBELY | ||||||||
| FirstName: | SAMANTHA | ||||||||
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| Credential: | NNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3331 EAGLE BUTTE AVE | ||||||||
| Address2: | |||||||||
| City: | FREDERICK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805169750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039063440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5555 W THUNDERBIRD RD | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853064622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028655555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2020 | ||||||||
| LastUpdateDate: | 07/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WN0002X | RN.1619902 | CO | Y | Nursing Service Providers | Registered Nurse | Neonatal Intensive Care |
No ID Information.