IndividualActive
Samantha Kodak, RN, CCRN, SRNA
NPI 1831947480 · Critical Care Medicine Registered Nurse · Charleston, SC
Provider details
- NPI number
- 1831947480
- Entity type
- Individual
- Primary specialty
- Critical Care Medicine Registered NurseNursing Service Providers
- Credential
- RN, CCRN, SRNA
- Sex
- Female
- Sole proprietor
- Yes
- License
- 818754 (NY)
Specialties & taxonomies
Nursing Service Providers
Practice location
151 Rutledge Ave Bldg a
Charleston, SC 29425-8903
Phone: (843) 792-3328
Approximate (ZIP-level) locationGet directions
Mailing address
79 Sherman Ave
West Islip, NY 11795-3213
Registry dates
- Enumerated
- 2024-05-08
- Last updated
- 2024-05-08
- Certified
- 2024-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.