Healthcare Provider Details

I. General information

NPI: 1114448867
Provider Name (Legal Business Name): CAMELIA BURROWS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 SUNFOREST DR
TAMPA FL
33634-6318
US

IV. Provider business mailing address

210 WESTWOOD PL
BRENTWOOD TN
37027-7554
US

V. Phone/Fax

Practice location:
  • Phone: 866-686-2504
  • Fax: 855-810-6183
Mailing address:
  • Phone: 866-686-2504
  • Fax: 855-810-6183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9318130
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9318130
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: