Provider Demographics
NPI:1891815056
Name:CHAMPLIN, FLORENCE M (RN,NPP)
Entity type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:M
Last Name:CHAMPLIN
Suffix:
Gender:F
Credentials:RN,NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2017
Mailing Address - Country:US
Mailing Address - Phone:315-703-2800
Mailing Address - Fax:
Practice Address - Street 1:742 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2017
Practice Address - Country:US
Practice Address - Phone:315-703-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332603-1363LF0000X
NYF401389-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily