Provider Demographics
NPI:1407651789
Name:SAMSULA, BARB
Entity type:Individual
Prefix:
First Name:BARB
Middle Name:
Last Name:SAMSULA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 S EAST ST APT 13
Mailing Address - Street 2:
Mailing Address - City:NELSON
Mailing Address - State:NE
Mailing Address - Zip Code:68961-4444
Mailing Address - Country:US
Mailing Address - Phone:602-583-5398
Mailing Address - Fax:
Practice Address - Street 1:151 S EAST ST APT 7
Practice Address - Street 2:
Practice Address - City:NELSON
Practice Address - State:NE
Practice Address - Zip Code:68961-4444
Practice Address - Country:US
Practice Address - Phone:910-650-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider