Provider Demographics
NPI:1639758816
Name:STRACHAN, SAMANTHA S
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:S
Last Name:STRACHAN
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 1:19565 BENNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-8239
Mailing Address - Country:US
Mailing Address - Phone:216-269-5195
Mailing Address - Fax:
Practice Address - Street 1:19565 BENNINGTON DR
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-8239
Practice Address - Country:US
Practice Address - Phone:216-269-5195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.469402163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice