Healthcare Provider Details

I. General information

NPI: 1578558664
Provider Name (Legal Business Name): NADINE L. CAMP CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 GOOD HOPE RD SE
WASHINGTON DC
20020-3011
US

IV. Provider business mailing address

1501 BRANCHWOOD CT.
GAMBRILLS MD
21054-2119
US

V. Phone/Fax

Practice location:
  • Phone: 202-884-6995
  • Fax: 202-884-6991
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN39729
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: