Healthcare Provider Details

I. General information

NPI: 1912802208
Provider Name (Legal Business Name): SAMANTHA DARLING
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28973 COUNTRY LN
FLAT ROCK MI
48134-9694
US

IV. Provider business mailing address

28973 COUNTRY LN
FLAT ROCK MI
48134-9694
US

V. Phone/Fax

Practice location:
  • Phone: 734-258-3890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number4703121431
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: