Healthcare Provider Details

I. General information

NPI: 1811743792
Provider Name (Legal Business Name): SAMANTHA NICOLE MAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MAY DR
HARRISON OH
45030-2024
US

IV. Provider business mailing address

3621 ROSSGATE CT
HAMILTON OH
45013-9558
US

V. Phone/Fax

Practice location:
  • Phone: 513-738-7600
  • Fax: 513-738-7601
Mailing address:
  • Phone: 513-738-7600
  • Fax: 513-738-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN.521961
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: