Healthcare Provider Details

I. General information

NPI: 1750495305
Provider Name (Legal Business Name): PEGGY E. KAMPER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CRAMPTON ST
RENO NV
89502-2480
US

IV. Provider business mailing address

680 S ROCK BLVD
RENO NV
89502-4113
US

V. Phone/Fax

Practice location:
  • Phone: 775-336-3700
  • Fax: 775-336-3701
Mailing address:
  • Phone: 775-336-3700
  • Fax: 775-336-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN17337
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: