Basic Information
Provider Information
NPI: 1598497158
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALAZZI
FirstName: SAMANTHA
MiddleName: SAXE
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 1211 NIGHTSHADE DR
Address2:  
City: DURHAM
State: NC
PostalCode: 277132576
CountryCode: US
TelephoneNumber: 9198106954
FaxNumber:  
Practice Location
Address1: 4420 LAKE BOONE TRL
Address2:  
City: RALEIGH
State: NC
PostalCode: 276077505
CountryCode: US
TelephoneNumber: 9197843100
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/30/2022
LastUpdateDate: 08/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X5016464NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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