Provider Demographics
NPI:1619574787
Name:KAMP, AMANDA LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:KAMP
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-4343
Mailing Address - Country:US
Mailing Address - Phone:301-533-3300
Mailing Address - Fax:301-533-3299
Practice Address - Street 1:1027 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-4343
Practice Address - Country:US
Practice Address - Phone:301-533-3300
Practice Address - Fax:301-533-3299
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR188668363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily