Provider Demographics
NPI:1831877968
Name:FAUST, SAMANTHA MAY (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MAY
Last Name:FAUST
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 WATERWORN CT
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5809
Mailing Address - Country:US
Mailing Address - Phone:484-925-4955
Mailing Address - Fax:
Practice Address - Street 1:5901 WATERWORN CT
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-5809
Practice Address - Country:US
Practice Address - Phone:484-925-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC327486163W00000X
NCL-309489163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse