Provider Demographics
NPI:1235927112
Name:KAMPA KEARNEY, LORI (NBC-HWC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:KAMPA KEARNEY
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15892 CINNAMON WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-3800
Mailing Address - Country:US
Mailing Address - Phone:612-720-1335
Mailing Address - Fax:
Practice Address - Street 1:15892 CINNAMON WAY
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3800
Practice Address - Country:US
Practice Address - Phone:612-720-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach