Individual
DESTINY PATRICE SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 E HOSPITAL ROAD, FORT EISENHOWER, GA 30905
(706) 787-5811
Mailing address
300 E HOSPITAL ROAD, FORT EISENHOWER, GA 30905
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1186260
AL
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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