Provider Demographics
NPI:1306457114
Name:BIRCHFIELD, SAMANTHA R
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:R
Last Name:BIRCHFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 JEFFERS RIDGE
Mailing Address - Street 2:
Mailing Address - City:SOUTHSIDE
Mailing Address - State:WV
Mailing Address - Zip Code:25187
Mailing Address - Country:US
Mailing Address - Phone:304-675-7585
Mailing Address - Fax:
Practice Address - Street 1:174 JEFFERS RIDGE
Practice Address - Street 2:
Practice Address - City:SOUTHSIDE
Practice Address - State:WV
Practice Address - Zip Code:25187
Practice Address - Country:US
Practice Address - Phone:304-675-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant