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Individual
SAMANTHA LYNN ZACK
Active
Individual
SAMANTHA LYNN ZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201706092RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
AP145570
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/16/2017
Last updated
03/13/2020
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