Provider Demographics
NPI:1609471358
Name:CAIN, SAMARAH LYNAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SAMARAH
Middle Name:LYNAE
Last Name:CAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 THRASHER RD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4344
Mailing Address - Country:US
Mailing Address - Phone:615-424-5229
Mailing Address - Fax:
Practice Address - Street 1:2414 THRASHER RD
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4344
Practice Address - Country:US
Practice Address - Phone:615-424-5229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN207083163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse