Basic Information
| Provider Information | |||||||||
| NPI: | 1881663391 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIAMPA | ||||||||
| FirstName: | SHERILL | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 2540 | ||||||||
| Address2: | |||||||||
| City: | NORTH CONWAY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038602540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033565472 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3073 WHITE MOUNTAIN HWY. | ||||||||
| Address2: | |||||||||
| City: | NORTH CONWAY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038605111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033565472 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 04/29/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 147797 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 060023-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 147797 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 39340 | 01 | MA | HARVARD PILGRIM | OTHER | 0317284 | 05 | MA | MEDICAID | NP3979 | 01 | MA | BLUE CROSS | OTHER |