Provider Demographics
NPI:1720403272
Name:KAMPER, SHELIA (RN)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:KAMPER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:10976 ARCHER STREET
Mailing Address - City:ROSEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43070-0027
Mailing Address - Country:US
Mailing Address - Phone:937-243-3518
Mailing Address - Fax:
Practice Address - Street 1:10976 ARCHER STREET
Practice Address - Street 2:
Practice Address - City:ROSEWOOD
Practice Address - State:OH
Practice Address - Zip Code:43070
Practice Address - Country:US
Practice Address - Phone:937-243-3518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.335841163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse