Provider Demographics
NPI:1851521470
Name:RUMPKE, AMANDA L (CNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:RUMPKE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MACK RD
Mailing Address - Street 2:STE. 120
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5335
Mailing Address - Country:US
Mailing Address - Phone:513-682-6975
Mailing Address - Fax:513-682-6976
Practice Address - Street 1:3000 MACK RD
Practice Address - Street 2:STE. 120
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5335
Practice Address - Country:US
Practice Address - Phone:513-682-6975
Practice Address - Fax:513-682-6976
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10765NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00762931OtherMEDICARE RR
OH2971842Medicaid
OHNP31311Medicare PIN