Provider Demographics
NPI:1649629049
Name:SPINKS, SAMANTHA LOGAN (APN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LOGAN
Last Name:SPINKS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 CHAMBLISS AVE NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3848
Mailing Address - Country:US
Mailing Address - Phone:423-339-2000
Mailing Address - Fax:423-339-2043
Practice Address - Street 1:2404 CHAMBLISS AVE NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3848
Practice Address - Country:US
Practice Address - Phone:423-339-2000
Practice Address - Fax:423-339-2043
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21159363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care