Provider Demographics
NPI:1881981751
Name:BRINKERHOFF, SAMANTHA DRAKE (CPM)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DRAKE
Last Name:BRINKERHOFF
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2325
Mailing Address - Country:US
Mailing Address - Phone:812-200-0441
Mailing Address - Fax:812-610-2857
Practice Address - Street 1:2100 N 12TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2325
Practice Address - Country:US
Practice Address - Phone:812-200-0441
Practice Address - Fax:812-610-2857
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL295.000016176B00000X
IN90000017A176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwife