Healthcare Provider Details

I. General information

NPI: 1831029008
Provider Name (Legal Business Name): SAMANTHA MCINTOSH CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N HOMER ST
LANSING MI
48912-4903
US

IV. Provider business mailing address

536 OKEMOS ST
MASON MI
48854-1225
US

V. Phone/Fax

Practice location:
  • Phone: 517-993-5815
  • Fax: 517-394-7716
Mailing address:
  • Phone: 517-993-5815
  • Fax: 517-394-7716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: