Provider Demographics
NPI:1184328387
Name:SAMS, NINA VICTORIA
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:VICTORIA
Last Name:SAMS
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 1:235 S CAMPUS VIEW DR APT 209
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1169
Mailing Address - Country:US
Mailing Address - Phone:910-507-5783
Mailing Address - Fax:
Practice Address - Street 1:235 S CAMPUS VIEW DR APT 209
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1169
Practice Address - Country:US
Practice Address - Phone:910-507-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant