Healthcare Provider Details

I. General information

NPI: 1316884794
Provider Name (Legal Business Name): GLADYS AMPARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 HOUSE AVE STE 110
CAMP HILL PA
17011-2308
US

IV. Provider business mailing address

207 HOUSE AVE STE 110
CAMP HILL PA
17011-2308
US

V. Phone/Fax

Practice location:
  • Phone: 717-972-2821
  • Fax:
Mailing address:
  • Phone: 717-972-2821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP035899
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: