1225511819 NPI number — ALLISON JANE KAMM CRNP

Table of content: ALLISON JANE KAMM CRNP (NPI 1225511819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225511819 NPI number — ALLISON JANE KAMM CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAMM
Provider First Name:
ALLISON
Provider Middle Name:
JANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOYER
Provider Other First Name:
ALLISON
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225511819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 WALNUT ST FL 17
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-5176
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-829-3523
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 WALNUT ST FL 17
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-5176
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-829-3523
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP019207 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)