Samantha Killen
Individual provider Active NPI Athletic Trainer · Windsor Locks, CT
NPI 1609388792 · NPPES record last updated Jul 14, 2021
Key facts
- NPI
- 1609388792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1363 (CT)
- Practice address
- 3 Helena LN
Windsor Locks, CT 06096-2110 - Phone
- (860) 817-8569
- NPI assigned
- Oct 29, 2017
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1363 | CT | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 1363 | CT | Yes |
Addresses
Primary practice location
3 Helena LN
Windsor Locks, CT 06096-2110
Mailing address
3 Helena LN
Windsor Locks, CT 06096-2110
Other providers in Windsor Locks, CT
- Holistic Healthcare
- House of Eve
- Jennell Ifill
- Jaquar Limo LLC
- Sheldon Kafer
- Chung K Kim
- Janet Konadu
- Albert George Lawson
- Kelie Lee
- Anaisia Nicole Lindsey
All providers in Windsor Locks, CT · Athletic Trainer in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 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.