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NPI 1356253058

NPI 1356253058 : SAMANTHA LYNN FARNSWORTH RDN, LD, CBS : CHARLESTON, WV

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General NPI Number Information
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    NPI Number           |    1356253058
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    Entity Type          |    Individual 
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    Provider Name        |    SAMANTHA LYNN FARNSWORTH RDN, LD, CBS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2026
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    Last Update Date     |    09/18/2026
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Provider Practice Location Address
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    Address Line         |    1220 LEE ST E STE 201 
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    City                 |    CHARLESTON
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    State                |    WV
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    Zip                  |    25301-1864
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    Country              |    US
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    Telephone            |    304-342-8513
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    524 ROXALANA HILLS DR APT 524 
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    City                 |    DUNBAR
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    State                |    WV
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    Zip                  |    25064-1936
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    Country              |    US
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    Telephone            |    
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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        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    86372363
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    License Number State |    
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