Healthcare Provider Details

I. General information

NPI: 1134874175
Provider Name (Legal Business Name): SAMANTHA PHILYAW BANKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA LEA PHILYAW

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 R L SAWYER MD DR
SALUDA SC
29138-9199
US

IV. Provider business mailing address

104 WELLS AVE
GREENWOOD SC
29646-3837
US

V. Phone/Fax

Practice location:
  • Phone: 864-445-2173
  • Fax:
Mailing address:
  • Phone: 864-725-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26792
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP002978
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: