Provider Demographics
NPI:1902409436
Name:ARBAUGH, SAMANTHA NICOLE
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:NICOLE
Last Name:ARBAUGH
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 1:169 EMORY LN
Mailing Address - Street 2:
Mailing Address - City:CABINS
Mailing Address - State:WV
Mailing Address - Zip Code:26855-8512
Mailing Address - Country:US
Mailing Address - Phone:681-242-1580
Mailing Address - Fax:
Practice Address - Street 1:169 EMORY LN
Practice Address - Street 2:
Practice Address - City:CABINS
Practice Address - State:WV
Practice Address - Zip Code:26855-8512
Practice Address - Country:US
Practice Address - Phone:681-242-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant