MEDICARE: CAMMIE MCKITTRICK ARMENTROUT NNP

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	363LN0000X	Neonatal Nurse Practitioner	RN252666	GA
2	363LN0000X	Neonatal Nurse Practitioner	31417	SC

General Provider Information

NPI Number	:	1942891627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMMIE MCKITTRICK ARMENTROUT NNP

Provider Business Mailing Address
First Line	:	450 BROOKRIDGE DR
Second Line	:
City	:	CHAPIN
State	:	SC
Zip	:	29036-9803
Country	:	US
Telephone Number	:	843-319-9550
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 RICHLAND MEDICAL PARK DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6863
Country	:	US
Telephone Number	:	803-296-5437
Fax Number	:

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

Provider Enumeration Date	:	01/27/2021
Last Update Date	:	06/01/2026

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