Provider Demographics
NPI:1386003028
Name:DIGGS, SAMANTHA (LPN)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:DIGGS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15853 WORMER
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3546
Mailing Address - Country:US
Mailing Address - Phone:313-784-8495
Mailing Address - Fax:
Practice Address - Street 1:15853 WORMER
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3546
Practice Address - Country:US
Practice Address - Phone:313-784-8495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703111536164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse