MS. SAMANTHA GAIL KODAK RN, CCRN, SRNA
NPI 1831947480
Registered Nurse - Critical Care Medicine in Charleston, SC

Q: What is the provider's specialty?

The provider's specialty is Registered Nurse with taxonomy code 163WC0200X and a focus in Critical Care Medicine.

Active since May 08, 2024

151 RUTLEDGE AVE BLDG A, CHARLESTON, SC 29425(843) 792-3328 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Ms. Samantha Gail Kodak Rn, Ccrn, Srna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SAMANTHA GAIL KODAK RN, CCRN, SRNA (NPI 1831947480) is an individual critical care medicine provider in Charleston, South Carolina, licensed in New York (818754) and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1831947480

Entity TypeIndividualFemale

Primary Taxonomy163WC0200X

Provider Legal NameMS. SAMANTHA GAIL KODAKCredential: RN, CCRN, SRNA

Location Address151 RUTLEDGE AVE BLDG ACharleston, SC 29425-8903

Mailing Address79 Sherman AveWest Islip, NY 11795-3213 · (631) 358-9496

Phone(843) 792-3328

Sole ProprietorYes

Enumeration DateMay 8, 2024

NPPES CertifiedMay 8, 2024

✔ NPI 1831947480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Critical Care MedicineNursing Service Providers

Taxonomy Code163WC0200X

License✔ Licensed in NY · 818754

151 RUTLEDGE AVE BLDG A, Charleston, SC 29425

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Other Providers at the Same Location NPPES 9

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