Provider Demographics
NPI:1194884429
Name:ZAMPICH, JANET LAUREN (NP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LAUREN
Last Name:ZAMPICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WINTER HAWK RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-8713
Mailing Address - Country:US
Mailing Address - Phone:276-632-6311
Mailing Address - Fax:
Practice Address - Street 1:705 PINEY FOREST RD
Practice Address - Street 2:DANVILLE VA CBOC
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2860
Practice Address - Country:US
Practice Address - Phone:434-710-4210
Practice Address - Fax:434-792-1471
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166084363LF0000X, 363LP0808X
NC0050-00018363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113002Medicaid
Q14989Medicare UPIN
004345P94Medicare ID - Type Unspecified