Provider Demographics
NPI:1417070228
Name:KAMMERER, SHIRLEY ANNE
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ANNE
Last Name:KAMMERER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1571
Mailing Address - Country:US
Mailing Address - Phone:732-682-4462
Mailing Address - Fax:973-837-8031
Practice Address - Street 1:66 OXFORD CT
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1571
Practice Address - Country:US
Practice Address - Phone:732-682-4462
Practice Address - Fax:973-837-8031
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA0008012190251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health