Provider Demographics
NPI:1699372383
Name:KIBLER, SAMANTHA (PA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:KIBLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7337 CARITAS CIR NW STE 150
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9128
Mailing Address - Country:US
Mailing Address - Phone:330-478-0001
Mailing Address - Fax:330-837-2646
Practice Address - Street 1:7337 CARITAS CIR NW STE 150
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9128
Practice Address - Country:US
Practice Address - Phone:330-478-0001
Practice Address - Fax:330-837-2646
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical