Provider Demographics
NPI:1700277829
Name:HALL, SAMANTHA (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17370
Mailing Address - Street 2:LOT 1857
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-0370
Mailing Address - Country:US
Mailing Address - Phone:916-705-7050
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 7720
Practice Address - Street 2:
Practice Address - City:CAMARGO
Practice Address - State:OK
Practice Address - Zip Code:73835-9728
Practice Address - Country:US
Practice Address - Phone:916-705-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program