Provider Demographics
NPI:1376301945
Name:ONEAL, SAMANTHA MARIE
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:MARIE
Last Name:ONEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:MARIE
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-0948
Mailing Address - Country:US
Mailing Address - Phone:318-350-7770
Mailing Address - Fax:888-892-3970
Practice Address - Street 1:1869 HIGHWAY 605
Practice Address - Street 2:
Practice Address - City:NEWELLTON
Practice Address - State:LA
Practice Address - Zip Code:71357
Practice Address - Country:US
Practice Address - Phone:318-350-7770
Practice Address - Fax:888-892-3970
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty