Provider Demographics
NPI:1881663391
Name:CIAMPA, SHERILL (NP)
Entity type:Individual
Prefix:
First Name:SHERILL
Middle Name:
Last Name:CIAMPA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2540
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2540
Mailing Address - Country:US
Mailing Address - Phone:603-356-5472
Mailing Address - Fax:
Practice Address - Street 1:3073 WHITE MOUNTAIN HWY.
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5111
Practice Address - Country:US
Practice Address - Phone:603-356-5472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA147797363L00000X, 363LF0000X
NH060023-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA39340OtherHARVARD PILGRIM
MA0317284Medicaid
MANP3979OtherBLUE CROSS
MAP73373Medicare UPIN
MANP3979OtherBLUE CROSS