Provider Demographics
NPI:1659621779
Name:TWYMAN, SAMANTHA DAWN (CNM)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DAWN
Last Name:TWYMAN
Suffix:
Gender:F
Credentials:CNM
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 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:
Practice Address - Street 1:9109 STONY POINT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1979
Practice Address - Country:US
Practice Address - Phone:804-327-8809
Practice Address - Fax:804-237-6637
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181449367A00000X
CA235630367A00000X
SC19380367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCMW0230Medicaid
SCPENDINGMedicare PIN