Provider Demographics
NPI:1457734758
Name:HARNOIS, SAMANTHA
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:
Last Name:HARNOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NYREE
Other - Middle Name:D
Other - Last Name:O'DONALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:150 MAIN ST
Mailing Address - Street 2:APT 3
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-4411
Mailing Address - Country:US
Mailing Address - Phone:401-252-6522
Mailing Address - Fax:
Practice Address - Street 1:150 MAIN ST
Practice Address - Street 2:APT 3
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885-4411
Practice Address - Country:US
Practice Address - Phone:401-252-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-04
Last Update Date:2015-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker