Provider Demographics
NPI:1750108809
Name:VERRONE, SAMANTHA (PSS)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:VERRONE
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 UPPER MINOT RD
Mailing Address - Street 2:
Mailing Address - City:POWNAL
Mailing Address - State:ME
Mailing Address - Zip Code:04069-6106
Mailing Address - Country:US
Mailing Address - Phone:917-885-4542
Mailing Address - Fax:
Practice Address - Street 1:3 UPPER MINOT RD
Practice Address - Street 2:
Practice Address - City:POWNAL
Practice Address - State:ME
Practice Address - Zip Code:04069-6106
Practice Address - Country:US
Practice Address - Phone:917-885-4542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME00372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion