Samone Pettway
Licensed Practical Nurse in Waterbury, Connecticut
1144894478- Practice location
- 855 Lakewood RD, Waterbury, CT 06704-5408
- Phone
- 860-793-3500
- Fax
- —
- Last updated
- May 20, 2021
Samone Pettway is a Licensed Practical Nurse based in Waterbury, CT. Samone Pettway practices in Waterbury, CT. The NPI Number for Samone Pettway is 1144894478 and holds a License No. 40373 (CT). The current practice location address for Samone Pettway is 855 Lakewood RD, Waterbury, CT 06704-5408 and can be reached out via phone at 860-793-3500.
Provider Profile Details
- NPI Number
- 1144894478
- Provider Name
- Samone Pettway
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 855 Lakewood RD, Waterbury, CT 06704-5408
- Phone Number
- 860-793-3500
- Primary Taxonomy
- Licensed Practical Nurse · 164W00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 20, 2021
- Last Update Date
- May 20, 2021
- Certification Date
- May 20, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 855 Lakewood RD
Waterbury, CT 06704-5408 - City
- Waterbury
- State
- Connecticut
- Zip
- 06704-5408
- Phone Number
- 860-793-3500
Provider Business Mailing Address Details
- Address
- 492 East St Apt 13
Plainville, CT 06062-3272 - City
- Plainville
- State
- CT
- Zip
- 06062-3272
- Phone Number
- 203-988-7366
License Information
- License Number
- 40373
- License State
- CT
- Taxonomy
- Licensed Practical Nurse · 164W00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Samone Pettway?
The NPI number of Samone Pettway is 1144894478. It was assigned on May 20, 2021 and is currently active in the NPPES registry.
What is the specialty of Samone Pettway?
Samone Pettway is registered under the primary taxonomy Licensed Practical Nurse (code 164W00000X), licensed in CT under license number 40373.
Where does Samone Pettway practice?
The practice location is 855 Lakewood RD, Waterbury, CT 06704-5408. The office can be reached at 860-793-3500 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1144894478 directly on the NPPES registry website.