MRS. SAMANTHA JEAN MCCOLLOUGH CRNP
NPI 1174042501
Nurse Practitioner - Family in Jack, AL

Q: What is Samantha Mccollough's NPI number?

The NPI number for Samantha Mccollough is 1174042501. It was assigned to this individual provider in the NPPES registry on September 18, 2017.

Q: What is Samantha Mccollough's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since September 18, 2017

1020 COUNTY ROAD 114, JACK, AL 36346(334) 830-4624(833) 320-2199 Get Directions Write a Review

NPPES record last updated: April 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2025, Dec 8, 2020, Oct 6, 2020 and 1 more (4 updates tracked since 2017).

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About Mrs. Samantha Jean Mccollough Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SAMANTHA JEAN MCCOLLOUGH CRNP (NPI 1174042501) is an individual family provider in Jack, Alabama, licensed in Alabama (1-143531) and active in the NPI registry since September 2017.

NPPES Registry Identity

NPI1174042501

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. SAMANTHA JEAN MCCOLLOUGHCredential: CRNP

Location Address1020 COUNTY ROAD 114Jack, AL 36346-6228

Mailing Address1020 County Road 114Jack, AL 36346-6228 · (334) 830-4624 · Fax (334) 853-0178

Phone(334) 830-4624

Fax(833) 320-2199

Sole ProprietorYes

Enumeration DateSeptember 18, 2017

Last NPPES UpdateApril 10, 20254 updates tracked since enumeration

NPPES CertifiedApril 10, 2025

✔ NPI 1174042501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AL · 1-143531

1020 COUNTY ROAD 114, Jack, AL 36346

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Mccollough's NPI number?

The NPI number for Samantha Mccollough is 1174042501. It was assigned to this individual provider in the NPPES registry on September 18, 2017.

Where is Samantha Mccollough located?

Samantha Mccollough practices at 1020 County Road 114, Jack, AL 36346. The listed phone number is (334) 830-4624.

What is Samantha Mccollough's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Samantha Mccollough was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.