Individual
SAMANTHA BRUNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
890 FUDGES CREEK RD, MILTON, WV 25541-8647
(609) 569-3574
Mailing address
890 FUDGES CREEK RD, MILTON, WV 25541-8647
(609) 569-3574
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
38645
WV
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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