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Samantha Jo Dates
Licensed Practical Nurse in Randolph, Wisconsin
NPI 1538767355

Samantha Jo Dates is a Licensed Practical Nurse based in Randolph, WI. Samantha Jo Dates practices in Randolph, WI. The NPI Number for Samantha Jo Dates is 1538767355 and holds a License No. 325608 (Wisconsin).

The current practice location address for Samantha Jo Dates is N8273 E Friesland Rd, Randolph, WI and can be reached out via phone at 920-296-7067.

Location: N8273 E Friesland Rd, Randolph, WI, 53956-9407
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538767355
Provider Name
Samantha Jo Dates
Credential
Provider Entity Type
Individual
Gender
Female
Address
N8273 E Friesland Rd, Randolph, WI, 53956-9407
Phone Number
920-296-7067
Fax Number
Provider Enumeration Date
10/14/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
N8273 E Friesland Rd
City
Randolph
State
Wisconsin
Zip
53956-9407
Phone Number
920-296-7067
Fax Number
person
Provider Business Mailing Address Details
Address
N8273 E Friesland Rd
City
Randolph
State
Wisconsin
Zip
53956-9407
Phone Number
920-296-7067
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
325608 (Wisconsin)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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