Provider Demographics
NPI:1730472549
Name:SAMSON, KRISTIN RUTH
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:RUTH
Last Name:SAMSON
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 1:170 CAMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-5171
Mailing Address - Country:US
Mailing Address - Phone:205-216-3279
Mailing Address - Fax:
Practice Address - Street 1:170 CAMBRIDGE LN
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-5171
Practice Address - Country:US
Practice Address - Phone:205-216-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR006233954332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment