Provider Demographics
NPI:1861760993
Name:STANCAMPIANO, KIM M (LPN)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:M
Last Name:STANCAMPIANO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HOBNAIL DR
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1872
Mailing Address - Country:US
Mailing Address - Phone:716-631-0702
Mailing Address - Fax:
Practice Address - Street 1:5 HOBNAIL DR
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1872
Practice Address - Country:US
Practice Address - Phone:716-631-0702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183785-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse