Provider Demographics
NPI:1649968629
Name:LAMP, TRISTA LEE
Entity type:Individual
Prefix:
First Name:TRISTA
Middle Name:LEE
Last Name:LAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16115 ORCHARD MEWS DR APT 208
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6259
Mailing Address - Country:US
Mailing Address - Phone:304-788-5467
Mailing Address - Fax:304-788-6363
Practice Address - Street 1:16115 ORCHARD MEWS DR APT 208
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6259
Practice Address - Country:US
Practice Address - Phone:304-788-5467
Practice Address - Fax:304-788-6363
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant