Healthcare Provider Details

I. General information

NPI: 1790945731
Provider Name (Legal Business Name): CAMILLE REES N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAMILLE CORDA

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 BUCKEYSTOWN PIKE
FREDERICK MD
21703-8331
US

IV. Provider business mailing address

15013 ROLLING HILLS DR
GLENWOOD MD
21738-9635
US

V. Phone/Fax

Practice location:
  • Phone: 240-379-6000
  • Fax: 240-379-6050
Mailing address:
  • Phone: 410-489-0769
  • Fax: 240-379-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR164112
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: