Provider Demographics
NPI:1134462278
Name:JAMES, SAMARIA S (RN)
Entity type:Individual
Prefix:
First Name:SAMARIA
Middle Name:S
Last Name:JAMES
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 1:76 SEATTLE TRL
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5530
Mailing Address - Country:US
Mailing Address - Phone:386-627-2066
Mailing Address - Fax:
Practice Address - Street 1:76 SEATTLE TRL
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5530
Practice Address - Country:US
Practice Address - Phone:386-627-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9376787314000000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility