Healthcare Provider Details

I. General information

NPI: 1326900051
Provider Name (Legal Business Name): SAMANTHA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 LAVEY LN
BAKER LA
70714-3774
US

IV. Provider business mailing address

3209 LAVEY LN
BAKER LA
70714-3774
US

V. Phone/Fax

Practice location:
  • Phone: 225-999-6616
  • Fax:
Mailing address:
  • Phone: 225-999-6616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number200424R23
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: