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General NPI Number Information
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NPI Number | 1396693461
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Entity Type | Individual
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Provider Name | SAMARIA WILKERSON
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Gender | Female
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 4350 E 136TH ST APT 111
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44105-6861
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Country | US
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Telephone | 440-725-8664
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Fax |
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Provider Business Mailing Address
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Address Line | 30620 CANNON RD
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City | SOLON
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State | OH
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Zip | 44139-1613
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Country | US
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Telephone | 440-725-8664
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | OH
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