MEDICARE: CAMERON RACHELLE MUNAFO CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0028303	OH

General Provider Information

NPI Number	:	1275119174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON RACHELLE MUNAFO CNP

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD
Second Line	:	BLDG B
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-991-3188
Fax Number	:	937-223-9811

Provider Business Practice Location Address
First Line	:	5390 DIXIE HWY
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-4124
Country	:	US
Telephone Number	:	513-868-2345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2021
Last Update Date	:	06/07/2022

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