Samantha Jo Dates

Licensed Practical Nurse · Randolph, WI

Individual Active NPI

NPI number 1538767355

Practice location

N8273 E Friesland Rd
Randolph, WI 53956-9407
Phone
(920) 296-7067

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NPI record

NPI
1538767355
Entity type
Individual (Type 1)
Enumeration date
October 14, 2020
Last updated
October 14, 2020
Certified
October 14, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Licensed Practical Nurse Primary 164W00000X 325608 WI

About Samantha Dates

Samantha Jo Dates is a healthcare provider registered in the NPI registry with the primary taxonomy Licensed Practical Nurse (code 164W00000X). The practice location is N8273 E Friesland Rd, Randolph, WI 53956-9407. The NPI number 1538767355 was assigned on October 14, 2020 and the record was last updated on October 14, 2020.

Samantha Dates lists a license in the registry: #325608 (WI) for Licensed Practical Nurse. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Samantha Jo Dates?

The NPI number is 1538767355.

What is the phone number of Samantha Dates?

The phone number listed for the practice location is (920) 296-7067.

Where is Samantha Dates located?

N8273 E Friesland Rd, Randolph, WI 53956-9407.

What is the taxonomy code for Samantha Dates?

The primary taxonomy code is 164W00000X – Licensed Practical Nurse.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.