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General NPI Number Information
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NPI Number | 1144592775
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Entity Type | Individual
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Provider Name | SAMANTHA CORMIER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2012
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 1214 COOLIDGE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2621
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Country | US
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Telephone | 985-285-3582
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Fax |
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Provider Business Mailing Address
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Address Line | 102 PLAINVIEW DR
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City | LAFAYETTE
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State | LA
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Zip | 70508-6304
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Country | US
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Telephone | 337-322-4182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP06741
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License Number State | LA
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