Provider Demographics
NPI:1881051902
Name:KLUMPP, LUKE (PA-C, AT)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:KLUMPP
Suffix:
Gender:M
Credentials:PA-C, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CROSSINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2878
Mailing Address - Country:US
Mailing Address - Phone:401-777-7000
Mailing Address - Fax:
Practice Address - Street 1:300 CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2878
Practice Address - Country:US
Practice Address - Phone:516-554-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer