Samantha J Blake
Individual provider Active NPI Personal Care Attendant · Kulm, ND
NPI 1285222018 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1285222018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 104 2ND St SE
Kulm, ND 58456-7245 - Phone
- (701) 830-9975
- NPI assigned
- Jan 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
104 2ND St SE
Kulm, ND 58456-7245
Mailing address
PO Box 165
Kulm, ND 58456-0165
Other providers in Kulm, ND
All providers in Kulm, ND · Personal Care Attendant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.