Samantha Elaine Harris

Individual provider Active NPI Licensed Vocational Nurse · Saint Jo, TX

NPI 1184124695 · NPPES record last updated Feb 20, 2018

Key facts

NPI
1184124695
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
330915 (TX)
Practice address
502 N Singletary St
Saint Jo, TX 76265-2137
Phone
(940) 641-2097
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
330915TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 330915 TX Yes

Addresses

Primary practice location

502 N Singletary St
Saint Jo, TX 76265-2137

Mailing address

502 N Singletary St
Saint Jo, TX 76265-2137
Phone (940) 641-2097

Other providers in Saint Jo, TX

All providers in Saint Jo, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.