Provider Demographics
NPI:1952553877
Name:BARNETTE, SAMANTHA HOPE
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:HOPE
Last Name:BARNETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:HOPE
Other - Last Name:BROGDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1290 W GOVERNMENT ST
Mailing Address - Street 2:APT N 112
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2440
Mailing Address - Country:US
Mailing Address - Phone:601-500-0471
Mailing Address - Fax:
Practice Address - Street 1:1290 W GOVERNMENT ST
Practice Address - Street 2:APT N 112
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2440
Practice Address - Country:US
Practice Address - Phone:601-500-0471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist