Provider Demographics
NPI:1508683301
Name:WAMPLER, CORINNE-RAE EVALINE
Entity type:Individual
Prefix:MRS
First Name:CORINNE-RAE
Middle Name:EVALINE
Last Name:WAMPLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 COSMOS DR
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2005
Mailing Address - Country:US
Mailing Address - Phone:937-510-8895
Mailing Address - Fax:
Practice Address - Street 1:241 COSMOS DR
Practice Address - Street 2:
Practice Address - City:WEST CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:45449-2005
Practice Address - Country:US
Practice Address - Phone:937-510-8895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker