Provider Demographics
NPI:1316548894
Name:LEMPKE, R. MARYAM (RN, PMHNP)
Entity Type:Individual
Prefix:
First Name:R. MARYAM
Middle Name:
Last Name:LEMPKE
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:WALES
Mailing Address - State:MA
Mailing Address - Zip Code:01081-9618
Mailing Address - Country:US
Mailing Address - Phone:413-348-9877
Mailing Address - Fax:
Practice Address - Street 1:2 ALLEN ST
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9552
Practice Address - Country:US
Practice Address - Phone:413-450-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2272979163W00000X
MARN2272979363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse