Provider Demographics
NPI:1912633520
Name:SAMUEL, SAVANNAH JANE (BSN)
Entity Type:Individual
Prefix:MISS
First Name:SAVANNAH
Middle Name:JANE
Last Name:SAMUEL
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 HEALTH SCIENCES BUILDING
Mailing Address - Street 2:MAIL STOP 162
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4353
Mailing Address - Country:US
Mailing Address - Phone:252-744-6401
Mailing Address - Fax:
Practice Address - Street 1:3112 HEALTH SCIENCES BUILDING
Practice Address - Street 2:MAIL STOP 162
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4353
Practice Address - Country:US
Practice Address - Phone:252-744-6401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program