Individual provider · Type 1 NPI

Samantha Gregory Dagenhardt, RN, MS, MSN, PMHCNS-

Psychiatric/Mental Health Nurse Practitioner · Port Washington, WI

NPI number 1659642841 Active

Practice location

121 W Main St
Port Washington, WI 53074-1813

Fax (262) 284-8209

Other practice locations

  • 1220 Dewey Ave, Wauwatosa, WI 53213-2504 · (414) 454-6566

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X4747-33 (WI)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X4747-33 (WI)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1659642841

Samantha Gregory Dagenhardt, RN, MS, MSN, PMHCNS-'s National Provider Identifier is 1659642841, issued on Jan 19, 2012. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Port Washington, WI. The record was last updated on Mar 7, 2023.