Provider Demographics
NPI:1023157633
Name:PULLINS, SAMANTHA DIANE (AHA, AS MA)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:DIANE
Last Name:PULLINS
Suffix:
Gender:F
Credentials:AHA, AS MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 PINE CROSSINGS CIR APT 513
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-8283
Mailing Address - Country:US
Mailing Address - Phone:772-342-0789
Mailing Address - Fax:407-644-9503
Practice Address - Street 1:7920 PINE CROSSINGS CIR APT 513
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-8283
Practice Address - Country:US
Practice Address - Phone:772-342-0789
Practice Address - Fax:407-644-9503
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program