Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 6062-33 | WI |
NPI | 1003210725 |
---|---|
Provider Name | Mrs. Kristen Kay Lampe |
First Address | Green Bay, WI 54305-2487 |
Second Address | Green Bay, WI 54301-3538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2014 |
Last Update Date | 15/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2000240333 | AMERICAN ASSOCIATION OF CRITICAL CARE NURSES (01) | |
2014009761 | AMERICAN NURSES CREDENTIALING CENTER (01) |