Provider Demographics
NPI:1265529671
Name:LAMPLEY, CARRIE A (APRN)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:A
Last Name:LAMPLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:A
Other - Last Name:NIELSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:40 CROSS ST
Mailing Address - Street 2:4TH FL
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-4647
Mailing Address - Country:US
Mailing Address - Phone:203-845-4827
Mailing Address - Fax:203-845-4870
Practice Address - Street 1:40 CROSS ST
Practice Address - Street 2:4TH FL
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4647
Practice Address - Country:US
Practice Address - Phone:203-845-4827
Practice Address - Fax:203-845-4870
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002978363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO004248846Medicaid
CT500001242Medicare ID - Type Unspecified
CO004248846Medicaid