Provider Demographics
NPI:1831951490
Name:DUNN, SAMANTHA JOYCE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JOYCE
Last Name:DUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 FAYETTEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-3655
Mailing Address - Country:US
Mailing Address - Phone:479-632-4622
Mailing Address - Fax:479-430-7596
Practice Address - Street 1:344 FAYETTEVILLE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-3655
Practice Address - Country:US
Practice Address - Phone:479-632-4622
Practice Address - Fax:479-430-7596
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR214028163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse