Provider Demographics
NPI:1417664236
Name:HALL, SAMANTHA C
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:C
Last Name:HALL
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 1:2611 COUNTY HIGHWAY 96 APT 105
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:OH
Mailing Address - Zip Code:43316-1189
Mailing Address - Country:US
Mailing Address - Phone:419-721-3930
Mailing Address - Fax:
Practice Address - Street 1:2611 COUNTY HIGHWAY 96 APT 105
Practice Address - Street 2:
Practice Address - City:CAREY
Practice Address - State:OH
Practice Address - Zip Code:43316-1189
Practice Address - Country:US
Practice Address - Phone:419-721-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician