# SAMANTHA DASTRUP

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245854165
- **Gender:** F
- **Credential:** AGNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | 95038256 | CA | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | NP500339167 | DC | — |
| 363LG0600X | Gerontology Nurse Practitioner | 242012 | AZ | Yes |

## Other

- **Enumeration date:** 06/05/2020
- **Last updated:** 04/06/2026