Healthcare Provider Details

I. General information

NPI: 1922938760
Provider Name (Legal Business Name): SAMANTHA RAE DOWNING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH ST STE D
VIENNA WV
26105-2176
US

IV. Provider business mailing address

1200 31ST ST APT 1
PARKERSBURG WV
26104-2459
US

V. Phone/Fax

Practice location:
  • Phone: 304-428-6148
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberD214-606-38-000-0
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: