Provider Demographics
NPI:1194374173
Name:HARMON, SAMANTHA (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:HARMON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 E WHITESTONE BLVD STE 2104
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-9079
Mailing Address - Country:US
Mailing Address - Phone:512-260-8100
Mailing Address - Fax:
Practice Address - Street 1:1464 E WHITESTONE BLVD STE 2104
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-9079
Practice Address - Country:US
Practice Address - Phone:512-260-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141275363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics