Provider Demographics
NPI:1952936288
Name:CODES, SAMANTHA (RN)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:CODES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7704 MATAPEAKE BUSINESS DR STE 315
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-3043
Mailing Address - Country:US
Mailing Address - Phone:301-856-3062
Mailing Address - Fax:301-856-3113
Practice Address - Street 1:7704 MATAPEAKE BUSINESS DR STE 315
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-3043
Practice Address - Country:US
Practice Address - Phone:301-856-3062
Practice Address - Fax:301-856-3113
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR228960163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse