Provider Demographics
NPI:1699958280
Name:EVANS, SAMANTHA SHALEY (LM CPM BSN-SDNP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SHALEY
Last Name:EVANS
Suffix:
Gender:F
Credentials:LM CPM BSN-SDNP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:SHALEY
Other - Last Name:GERMANY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM CPM BSN-SDNP
Mailing Address - Street 1:948 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7049
Mailing Address - Country:US
Mailing Address - Phone:512-749-8708
Mailing Address - Fax:737-263-1804
Practice Address - Street 1:948 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7049
Practice Address - Country:US
Practice Address - Phone:512-738-1509
Practice Address - Fax:512-878-2279
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05015176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife