Provider Demographics
NPI:1720023161
Name:LAMPE, TERESA J (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:J
Last Name:LAMPE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2718
Mailing Address - Country:US
Mailing Address - Phone:419-668-2686
Mailing Address - Fax:419-663-6637
Practice Address - Street 1:278 BENEDICT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2399
Practice Address - Country:US
Practice Address - Phone:419-668-2686
Practice Address - Fax:419-663-6637
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP05205363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2234862Medicaid
OH2234862Medicaid