Individual
SAMANTHA GAIL STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,FA,CNOR
Contact information
Practice address
80 HUMPHREYS CTR STE 100, MEMPHIS, TN 38120-2352
(901) 761-9030
(901) 473-6505
Mailing address
PO BOX 1000 DEPT 245, MEMPHIS, TN 38148-0001
(901) 761-9030
(901) 473-6505
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN0000152703
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085478
RN, CNOR
—
01
—
RN0000152703
RN LICENSE
TN
Enumeration date
07/16/2009
Last updated
07/16/2009
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