Provider Demographics
NPI:1740714468
Name:CHAUMP, JENNY LYNN (RRT)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:LYNN
Last Name:CHAUMP
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3719
Mailing Address - Country:US
Mailing Address - Phone:570-954-3464
Mailing Address - Fax:
Practice Address - Street 1:122 BEE ST
Practice Address - Street 2:SUITE 201 CHARLESTON
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8912
Practice Address - Country:US
Practice Address - Phone:570-954-3464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR153682227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered