Provider Demographics
NPI:1407299068
Name:LUNNIE, SAMANTHA KING
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KING
Last Name:LUNNIE
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 1:4635 WHIPPLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-7305
Mailing Address - Country:US
Mailing Address - Phone:540-769-3348
Mailing Address - Fax:
Practice Address - Street 1:4635 WHIPPLEWOOD CT
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-7305
Practice Address - Country:US
Practice Address - Phone:540-769-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-14
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist