Individual
ORENA SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
CORNER OF ROUTE N12 & N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN127921
AZ
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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