Provider Demographics
NPI:1821361650
Name:KAMPS, CHARISSA M (FNP)
Entity Type:Individual
Prefix:
First Name:CHARISSA
Middle Name:M
Last Name:KAMPS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 W RIVER RD STE 126
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3080
Mailing Address - Country:US
Mailing Address - Phone:520-219-6616
Mailing Address - Fax:520-742-6187
Practice Address - Street 1:3870 W RIVER RD STE 126
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3080
Practice Address - Country:US
Practice Address - Phone:520-219-6616
Practice Address - Fax:520-742-6187
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN113854163W00000X
AZAP4219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse