IndividualActive
Samantha Kisamore
NPI 1245848928 · Nurse's Aide · Petersburg, WV
Provider details
- NPI number
- 1245848928
- Entity type
- Individual
- Primary specialty
- Nurse's AideNursing Service Related Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 80681 (WV)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
12 Maple Hill Ave Ste 1
Petersburg, WV 26847-1547
Phone: (304) 257-9298
Approximate (ZIP-level) locationGet directions
Mailing address
12 Maple Hill Ave Ste 1
Petersburg, WV 26847-1547
Registry dates
- Enumerated
- 2020-07-17
- Last updated
- 2020-07-17
- Certified
- 2020-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.