MEDICARE: SAMANTHA DAWN TWYMAN CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	0024181449	VA

General Provider Information

NPI Number	:	1659621779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA DAWN TWYMAN CNM

Provider Business Mailing Address
First Line	:	PO BOX 780125
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-0125
Country	:	US
Telephone Number	:	804-922-4844
Fax Number	:

Provider Business Practice Location Address
First Line	:	9109 STONY POINT DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-1979
Country	:	US
Telephone Number	:	804-327-8809
Fax Number	:	804-237-6637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	03/08/2024

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