Provider Demographics
NPI:1750495305
Name:KAMPER, PEGGY E (APRN)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:E
Last Name:KAMPER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 S ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4113
Mailing Address - Country:US
Mailing Address - Phone:775-336-3700
Mailing Address - Fax:775-336-3701
Practice Address - Street 1:330 CRAMPTON ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2480
Practice Address - Country:US
Practice Address - Phone:775-336-3700
Practice Address - Fax:775-336-3701
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN17337163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
G60823Medicare UPIN