Individual
KATHERINE ALLENE SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(580) 332-2323
(580) 421-6042
Mailing address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(580) 332-2323
(580) 421-6042
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
106-22772
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00037002001
BLUE CROSS BLUE SHIELD
—
05
—
100728840A
—
OK
01
—
1619938040
STATE OF OKLAHOMA
—
Enumeration date
04/03/2009
Last updated
04/03/2009
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