Individual
SAMANTHA TARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17866 GRAY MOSS AVENUE, BATON ROUGE, LA 70817-1737
(504) 256-1138
Mailing address
17866 GRAY MOSS AVE, BATON ROUGE, LA 70817-1737
(504) 256-1138
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
150850
LA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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