Individual
MR. TOMMY WAYNE SAMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
500 N NAPPANEE ST, SUITE 11B, ELKHART, IN 46514-1503
(574) 522-9922
(574) 522-9926
Mailing address
500 N NAPPANEE ST, SUITE 11B, ELKHART, IN 46514-1503
(574) 522-9922
(574) 522-9926
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
101222
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
2016033441
MO
Other
Enumeration date
09/06/2013
Last updated
02/03/2022
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