Healthcare Provider Details

I. General information

NPI: 1639982572
Provider Name (Legal Business Name): SAMANTHA CADWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N 4TH ST
NORFOLK NE
68701-4003
US

IV. Provider business mailing address

2416 W MADISON AVE
NORFOLK NE
68701-4433
US

V. Phone/Fax

Practice location:
  • Phone: 402-371-1147
  • Fax: 402-371-1218
Mailing address:
  • Phone: 712-898-0608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: