Provider Demographics
NPI:1992377410
Name:WALTERS, SAMANTHA R (DOULA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:R
Last Name:WALTERS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 CULBERTSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1702
Mailing Address - Country:US
Mailing Address - Phone:026-480-1745
Mailing Address - Fax:
Practice Address - Street 1:1722 CULBERTSON AVE
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1702
Practice Address - Country:US
Practice Address - Phone:026-480-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula