Healthcare Provider Details

I. General information

NPI: 1477346757
Provider Name (Legal Business Name): ANAND KAMAL DAMPELLA DNP, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KAMAL DAMPELLA DNP, FNP-BC

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 JOSEPH CAMPAU ST STE F
HAMTRAMCK MI
48212-2590
US

IV. Provider business mailing address

12101 JOSEPH CAMPAU ST STE F
HAMTRAMCK MI
48212-2590
US

V. Phone/Fax

Practice location:
  • Phone: 313-893-6218
  • Fax: 313-444-1452
Mailing address:
  • Phone: 313-893-6218
  • Fax: 313-444-1452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704356311
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: