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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. SAMANTHA YATES NUCKOLS, PA-C

Active

MRS. SAMANTHA YATES NUCKOLS, PA-C is a Physician Assistant healthcare provider located in CREVE COEUR, Missouri. NPI 1316353121 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · CREVE COEUR, MO

Registration Details

NPI Number
1316353121
Provider Type
Individual
Gender
Female
NPI Issued
Jul 2, 2014 (12.102848877437 yrs)
Last Updated
Sep 24, 2019
Licenses
0110-004588 (VA)
2017044296 (MO)

Practice Information

Address
11445 OLIVE BLVD
CREVE COEUR, MO, 631417108
Browse MO providers · Browse ZIP 63141
Phone
3144289543
Fax
3144289542
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in CREVE COEUR, MO

Name Credential NPI
MS. AMIE C CHANG P.A. 1366557209
MR. ALLEN E MATHIEU PAC,ATC,MS 1699850529
MRS. LORI LEE MCLEOD PA-C 1932363462
AMY MICHELLE ROSE PA-C 1992949531
KEMIN CHEN PA 1326278102
MR. LUKE ANDREW SHOULDERS PA-C 1659895266
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.