Healthcare Provider Details

I. General information

NPI: 1376301945
Provider Name (Legal Business Name): MRS. SAMANTHA MARIE ONEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. SAMANTHA MARIE CUMMINGS

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

589 BLACK BAYOU RD
FERRIDAY LA
71334-4011
US

IV. Provider business mailing address

PO BOX 52
MONROE LA
71210-0052
US

V. Phone/Fax

Practice location:
  • Phone: 318-853-9249
  • Fax: 888-892-3970
Mailing address:
  • Phone: 318-853-9249
  • Fax: 888-892-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: