Provider Demographics
NPI:1346639473
Name:NORRIS, SAMANTHA HASTIE (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:HASTIE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:HASTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1040 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-8413
Mailing Address - Country:US
Mailing Address - Phone:650-823-3681
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1563
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95045814163W00000X
CA95014564363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse