Healthcare Provider Details

I. General information

NPI: 1912390998
Provider Name (Legal Business Name): LAURA LAMPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2015
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 MESA COLLEGE DR # I4209
SAN DIEGO CA
92111-4998
US

IV. Provider business mailing address

1519 FELSPAR ST
SAN DIEGO CA
92109-3008
US

V. Phone/Fax

Practice location:
  • Phone: 619-388-2774
  • Fax:
Mailing address:
  • Phone: 314-609-2422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001631
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number801485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: