Provider Demographics
NPI:1396979605
Name:BARBRE, SAMANTHA BRITTANY (LPN)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:BRITTANY
Last Name:BARBRE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:SAMANTHA
Other - Middle Name:BRITTANY
Other - Last Name:KOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:5322 CAMELOT DR
Mailing Address - Street 2:APT A
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-4079
Mailing Address - Country:US
Mailing Address - Phone:513-885-3427
Mailing Address - Fax:
Practice Address - Street 1:5322 CAMELOT DR
Practice Address - Street 2:APT A
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-4079
Practice Address - Country:US
Practice Address - Phone:513-885-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 131161 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse