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General NPI Number Information
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NPI Number | 1255408779
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Entity Type | Individual
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Provider Name | NANCY J KAMPA MA, LP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7900 INTERNATIONAL DR SUITE 200
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1510
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Country | US
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Telephone | 612-725-7742
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Fax |
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Provider Business Mailing Address
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Address Line | 8821 PENN LAKE CIR
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City | MINNEAPOLIS
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State | MN
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Zip | 55431-2026
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Country | US
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Telephone | 952-888-0640
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP3441
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License Number State | MN
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