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Contact Information

SAMANTHA J VAN GINNEKEN, PA-C
8020 S RAINBOW BLVD STE 100
BOX #536
LAS VEGAS, NV89139-6494
 Phone: 432-210-8950
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SAMANTHA J VAN GINNEKEN · (Female)

NPI Number 1225315229
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 11/04/2011
Last updated 04/07/2016 - About 2 months ago
Sole proprietor 1 No
Identifiers
NV License # PA 1294
NV Medicaid 1225315229
NV Medicare PIN FU265X
NV Medicare PIN FU265Y
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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