Provider Demographics
NPI:1477830842
Name:SAMS, KARIN MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:MARIE
Last Name:SAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 DAVIES AVE
Mailing Address - Street 2:APT 5
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-8830
Mailing Address - Country:US
Mailing Address - Phone:585-319-6943
Mailing Address - Fax:
Practice Address - Street 1:355 DAVIES AVE
Practice Address - Street 2:APT 5
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-8830
Practice Address - Country:US
Practice Address - Phone:585-319-6943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-13
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296922164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse