Samantha B Wines, RN

Individual provider Active NPI Registered Nurse · Mineral Wells, WV

NPI 1740024587 · NPPES record last updated Jun 25, 2024

Key facts

NPI
1740024587
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
118504 (WV)
Practice address
340 Sharon St
Mineral Wells, WV 26150-3017
Phone
(304) 532-2421
NPI assigned
Jun 25, 2024
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
118504WVMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 118504 WV Yes

Addresses

Primary practice location

340 Sharon St
Mineral Wells, WV 26150-3017

Mailing address

340 Sharon St
Mineral Wells, WV 26150-3017
Phone (304) 532-2421

Other providers in Mineral Wells, WV

All providers in Mineral Wells, WV · Registered Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.