SAMANTHA DASTRUP (NPI# 1245854165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245854165 |
| Entity Type | Individual |
| Full Name | SAMANTHA DASTRUP |
| Credential | AGNP-C |
| Practice Address |
4688 W Tangerine Rd Marana AZ 85658-4862 |
| Mailing Address |
4688 W Tangerine Rd Apt 2105 Marana AZ 85658-4866 |
| Practice Telephone | 7193425809 |
| Mailing Telephone | 7193425809 |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2020-06-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
242012 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4688 W TANGERINE RD |
| City | MARANA |
| State | AZ |
| Zip Code | 85658-4862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801269055 | Brian James Schnurr Jr. | Chiropractor | 4688 W Tangerine Rd, Unit 9203, Marana, AZ 85658-4862 | 2015-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922628908 | Melinda H Connor | Counselor | 31907 South Davis Ranch Rd, Marana, AZ 85658 | 2020-04-20 |
| 1285120352 | Akdhc Surgery Center, LLC | Clinic/Center | 3600 W Tangerine Rd, Suite 100, Marana, AZ 85658 | 2018-07-02 |
| 1902392079 | Akdhc,llc | Internal Medicine | 3600 W Tangerine Rd, Suite 110, Marana, AZ 85658 | 2018-07-02 |
| 1215452339 | Judith Jones | Speech-Language Pathologist | 11411 N. Vista Ranch Pl, Marana, AZ 85658 | 2017-08-09 |
| 1821308594 | Diana J Marr | Respite Care | 35020 E Red I Ranch Road, Marana, AZ 85658 | 2010-10-15 |
| 1942531868 | Justin Clark | Pharmacist | 12050 N Dove Mt Blvd, Marana, AZ 85658 | 2010-01-15 |
| 1093759615 | Adolben Y Montesclaros | Emergency Medicine | 5224 W Dove Centre Rd, Marana, AZ 85658 | 2006-06-15 |
| 1821536897 | Erica Lynne Hede | Nurse Practitioner | 3630 W Tangerine Rd Ste 100, Marana, AZ 85658 | 2017-02-09 |
| 1497206767 | Marana Health Center, Inc | Clinic/Center | 5224 W Dove Centre Rd, Marana, AZ 85658 | 2016-10-20 |
| 1083876064 | Estela Rutiaga | Family Medicine | 5224 W Dove Centre Rd, Marana, AZ 85658 | 2008-06-30 |
| Find all providers in zip 85658 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425123 | Erin Jean Mcmanus-tomanek | Nurse Practitioner | 12851 N 142nd Ave, Surprise, AZ 85379-9502 | 2020-10-21 |
| 1154928463 | Willie Sellers | Nurse Practitioner | 15354 W Charter Oak Rd, Surprise, AZ 85379-9184 | 2020-10-08 |
| 1760090427 | Debra Shannon Witthar | Nurse Practitioner | 10515 W Santa Fe Dr Bldg B, Sun City, AZ 85351-3020 | 2020-07-20 |
| 1255955506 | Christy J Holloway | Nurse Practitioner | 2645 E Southern Ave, Tempe, AZ 85282-7649 | 2020-06-02 |
| 1013552124 | Alliance With The Covenant of The Trinity Arizona Inc | Nurse Practitioner | 2 N Central Ave Fl 18, Phoenix, AZ 85004-2322 | 2019-11-12 |
| 1184197691 | Waheed Olawoyin Olabode | Nurse Practitioner | 12853 S 184th Ave, Goodyear, AZ 85338-2642 | 2019-01-08 |
| 1508381880 | Marcie Marie Camblin | Nurse Practitioner | 16551 N Naegel Dr, Surprise, AZ 85374-5411 | 2017-08-08 |
| 1508105727 | Geriatric Health Services, Plc | Nurse Practitioner | 1013 W Longhorn Rd, Payson, AZ 85541-4282 | 2013-02-07 |
| 1194070227 | Debra Rouse Haber | Nurse Practitioner | 755 S Grapevine Loop, Benson, AZ 85602-7430 | 2012-07-15 |
| 1346504818 | Your Nurse Practitioner LLC | Nurse Practitioner | 6261 Boothwyn St, Prescott Valley, AZ 86314-6726 | 2012-06-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.