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Individual
SAMANTHA DASTRUP
Active
Individual
SAMANTHA DASTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
10007031
OR
363LA2200X
Adult Health Nurse Practitioner
242012
AZ
363LA2200X
Adult Health Nurse Practitioner
61302790
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
95038256
CA
363LA2200X
Adult Health Nurse Practitioner
NP500339167
DC
363LG0600X
Gerontology Nurse Practitioner
Primary
242012
AZ
Other
Enumeration date
06/05/2020
Last updated
04/06/2026
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