Individual
MS. SAMANTHA MICHELLE STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1044 GILBERT ST, FLINT, MI 48532-3527
(810) 422-7623
(810) 733-7623
Mailing address
500 HANCOCK ST, SAGINAW, MI 48602-4224
(989) 272-0204
(989) 797-3477
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703119950
MI
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/21/2014
Last updated
02/10/2025
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