Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SAMANTHA MARIE GUDGEON NURSE PRACTITIONER
NPI 1174443261
Nurse Practitioner in Coon Rapids, MN

Q: What is Samantha Gudgeon's NPI number?

The NPI number for Samantha Gudgeon is 1174443261. It was assigned to this individual provider in the NPPES registry on July 17, 2026. The provider is also known as Samantha Marie Pitts.

Q: What is Samantha Gudgeon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Gudgeon was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days 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.

Active since July 17, 2026

4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433(763) 427-9980(763) 236-8903 Get Directions Write a Review

NPPES record added: July 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Samantha Marie Gudgeon Nurse Practitioner NPPES

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

SAMANTHA MARIE GUDGEON NURSE PRACTITIONER (NPI 1174443261) is an individual nurse practitioner in Coon Rapids, Minnesota, licensed in Minnesota (14503) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1174443261

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSAMANTHA MARIE GUDGEONCredential: NURSE PRACTITIONER

Location Address4040 COON RAPIDS BLVD NW STE 120Coon Rapids, MN 55433-4568

Mailing Address4040 Coon Rapids Blvd Nw Ste 120Coon Rapids, MN 55433-4568 · (763) 427-9980 · Fax (763) 236-8903

Phone(763) 427-9980

Fax(763) 236-8903

Sole ProprietorNo

Enumeration DateJuly 17, 2026

NPPES CertifiedJune 18, 2026

✔ NPI 1174443261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MN · 14503

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4040 COON RAPIDS BLVD NW STE 120, Coon Rapids, MN 55433

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Other Names 1

Former Name (1)Samantha Marie Pitts

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ASHLEE ANN TAYLOR PA-C

Physician Assistant