Healthcare Provider Details

I. General information

NPI: 1558471979
Provider Name (Legal Business Name): DONNA FRANCIS-SAMUELS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 ATHERHOLT RD
LYNCHBURG VA
24501-2148
US

IV. Provider business mailing address

2410 ATHERHOLT RD
LYNCHBURG VA
24501-2148
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-1800
  • Fax:
Mailing address:
  • Phone: 434-200-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110009837
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC03721
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA051604
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: