Healthcare Provider Details

I. General information

NPI: 1003752502
Provider Name (Legal Business Name): SAMANTHA P HUNT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 BETHEL DR
SAINT PAUL MN
55112-6902
US

IV. Provider business mailing address

8688 CARRIAGE HILL RD
SAVAGE MN
55378-2380
US

V. Phone/Fax

Practice location:
  • Phone: 651-638-6400
  • Fax:
Mailing address:
  • Phone: 612-860-0343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: