Provider Demographics
NPI:1386841948
Name:CAMP, KIERSTEN DAWN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KIERSTEN
Middle Name:DAWN
Last Name:CAMP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 LAZY DAY LN.
Mailing Address - Street 2:
Mailing Address - City:ANDALE
Mailing Address - State:KS
Mailing Address - Zip Code:67001
Mailing Address - Country:US
Mailing Address - Phone:316-444-2541
Mailing Address - Fax:
Practice Address - Street 1:1 CESSNA BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67215-1400
Practice Address - Country:US
Practice Address - Phone:316-517-8775
Practice Address - Fax:316-517-8063
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily