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Individual

ELIZABETH SAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
1623 HOSPITAL LOOP, OWYHEE, NV 89832-1200
(775) 757-2415
(775) 757-2066
Mailing address
PO BOX 159, OWYHEE, NV 89832-0159

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R40849
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R40849
RN LICENSE
ND
Enumeration date
10/09/2014
Last updated
10/09/2014
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