Provider Demographics
NPI:1114491891
Name:KAMPF, COLLEEN (MSN, AGPCNP-C)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:KAMPF
Suffix:
Gender:F
Credentials:MSN, AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2494 BERNVILLE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9467
Mailing Address - Country:US
Mailing Address - Phone:267-243-4901
Mailing Address - Fax:
Practice Address - Street 1:233 YOST AVE
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-1737
Practice Address - Country:US
Practice Address - Phone:267-243-4901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN647429163W00000X
PASP021589363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse