Provider Demographics
NPI:1073511986
Name:LAMP, JUDITH KILMER (CNM)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:KILMER
Last Name:LAMP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 N COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3895
Mailing Address - Country:US
Mailing Address - Phone:419-291-8541
Mailing Address - Fax:419-480-1340
Practice Address - Street 1:2142 N COVE BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3895
Practice Address - Country:US
Practice Address - Phone:419-291-8541
Practice Address - Fax:419-480-1340
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06328176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH05225OtherPARAMOUNT
OH2233256Medicaid
OH344428256084OtherCARESOURCE
OH344428256OtherHEALTH NET
CA344428256OtherBEECH STREET
MI4287066OtherMI MEDICAID
OH000000246729OtherANTHEM
OH420001260OtherOHIO RAILROAD MEDICARE
OH27886Medicare UPIN
OH344428256OtherHEALTH NET
OHNM76091Medicare PIN