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General NPI Number Information
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NPI Number | 1225244049
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Entity Type | Individual
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Provider Name | LISA ANNE KAMKE LPN
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 38 SHUFELDT STREET
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City | KINGSTON
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State | NY
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Zip | 12401
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Country | US
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Telephone | 845-338-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 16 OLD POST RD NORTH
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City | RED HOOK
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State | NY
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Zip | 12571-2219
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Country | US
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Telephone | 845-758-1738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 1327411
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License Number State | NY
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