Provider Demographics
NPI:1558889667
Name:VAMPER, LATASHA M
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:M
Last Name:VAMPER
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 1:2025 SPRING GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-5431
Mailing Address - Country:US
Mailing Address - Phone:434-728-7732
Mailing Address - Fax:
Practice Address - Street 1:2025 SPRING GARDEN ROAD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531
Practice Address - Country:US
Practice Address - Phone:434-728-7732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator