Provider Demographics
NPI:1689556383
Name:BRUNKER, SAMANTHA S
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:S
Last Name:BRUNKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 KULALOA RD
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3571
Mailing Address - Country:US
Mailing Address - Phone:208-720-6466
Mailing Address - Fax:
Practice Address - Street 1:88 KANOELEHUA AVE STE B107
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4685
Practice Address - Country:US
Practice Address - Phone:808-933-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program