Individual provider · Type 1 NPI

Samantha Jo Roach, FNP-C

Family Nurse Practitioner · Canton, IL

NPI number 1629940465 Active

Practice location

210 W Walnut St
Canton, IL 61520-2444

Mailing address

3994 N Fisk Rd
Astoria, IL 61501-8750

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209033247 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1629940465

Samantha Jo Roach, FNP-C's National Provider Identifier is 1629940465, issued on Sep 22, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Canton, IL. The record was last updated on Sep 22, 2025.