Provider Demographics
NPI:1528373495
Name:SAMS, PATRICIA ANN (PMHNP-BC,FNP-BC,APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:SAMS
Suffix:
Gender:F
Credentials:PMHNP-BC,FNP-BC,APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 436
Mailing Address - Street 2:
Mailing Address - City:SNOWSHOE
Mailing Address - State:WV
Mailing Address - Zip Code:26209
Mailing Address - Country:US
Mailing Address - Phone:740-350-8935
Mailing Address - Fax:740-423-4228
Practice Address - Street 1:7 WABASSO DRIVE
Practice Address - Street 2:
Practice Address - City:SNOWSHOE
Practice Address - State:WV
Practice Address - Zip Code:26209
Practice Address - Country:US
Practice Address - Phone:304-572-3978
Practice Address - Fax:740-423-4228
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11689-NP363L00000X
OHAPRN11689-NP363L00000X
WVAPRN46543363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA.11689-NPOtherLICENSE NUMBER