Doctor Name: | DEBORAH J SAMPLES |
NPI Number: | 1346519543 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | RN228886COA1 |
Business Practice Address: | 122 Columbus Rd Fredericktown, OH - 430191266 |
Business Phone Number: | 7406941261 |
Business Fax Number: | 7406947145 |
Mailing Address: | 2500 Corporate Exchange Dr, Suite 100 COLUMBUS |
State: | OH |
Postal Code: | 432317665 |
Phone Number: | 7647944500 |
Fax Number: | 6147944976 |
NPI Enumeration Date: | 12/19/2011 |
NPI Last Update Date: | 12/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN228886COA1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |