Individual
SAMANTHA MACIOLEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10571 TELEGRAPH RD STE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
Mailing address
225 LAURADELL RD, ASHLAND, VA 23005-8217
(614) 905-1755
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024188483
VA
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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