Provider Demographics
NPI:1407841992
Name:KAMMLER, ALICIA DOREEN (CNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:DOREEN
Last Name:KAMMLER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:DOREEN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:272 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9031
Mailing Address - Country:US
Mailing Address - Phone:740-779-4222
Mailing Address - Fax:740-779-4257
Practice Address - Street 1:1000 VETERANS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9586
Practice Address - Country:US
Practice Address - Phone:740-395-8090
Practice Address - Fax:740-395-8197
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08187363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2626144Medicaid
OHNP19474Medicare PIN