Provider Demographics
NPI:1699480343
Name:PEAIRSON, SAMANTHA J (MSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:J
Last Name:PEAIRSON
Suffix:
Gender:F
Credentials:MSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 ZION HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76088-7438
Mailing Address - Country:US
Mailing Address - Phone:817-694-1840
Mailing Address - Fax:
Practice Address - Street 1:3770 ZION HILL RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76088-7438
Practice Address - Country:US
Practice Address - Phone:817-694-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX961368163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant