Provider Demographics
NPI:1093482242
Name:HURLBUT, SAMANTHA DELYNN (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DELYNN
Last Name:HURLBUT
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 BONHAM RANCH RD
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5133
Mailing Address - Country:US
Mailing Address - Phone:832-465-3142
Mailing Address - Fax:
Practice Address - Street 1:630 W 34TH ST STE 301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1217
Practice Address - Country:US
Practice Address - Phone:832-465-3142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1052242363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health