Provider Demographics
NPI:1033816558
Name:SAMPLES, ASHLEY JO
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JO
Last Name:SAMPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 DOGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143-2025
Mailing Address - Country:US
Mailing Address - Phone:681-344-9502
Mailing Address - Fax:
Practice Address - Street 1:401 DOGWOOD ST
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143-2025
Practice Address - Country:US
Practice Address - Phone:681-344-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant