Provider Demographics
NPI:1619663283
Name:KAMMER, BRIANNA ILENE (LPN)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ILENE
Last Name:KAMMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 SOMB MOORE WAYS
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-1492
Mailing Address - Country:US
Mailing Address - Phone:812-240-7479
Mailing Address - Fax:
Practice Address - Street 1:844 SOMB MOORE WAYS
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-1492
Practice Address - Country:US
Practice Address - Phone:812-240-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002101972164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse