Individual
SAMUEL LECATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1834 GRAVES MILL RD, FOREST, VA 24551
(800) 277-8151
(336) 841-6217
Mailing address
PO BOX 14489, ARCHDALE, NC 27263-7489
(800) 277-8151
(336) 841-6217
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
110650
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
151711
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010029601
—
VA
Enumeration date
05/27/2005
Last updated
08/04/2009
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