Healthcare Provider Details

I. General information

NPI: 1225671399
Provider Name (Legal Business Name): EMILY CAROLINE CAMERON-HESSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 SHAFFER ST.
KALAMAZOO MI
49048-1604
US

IV. Provider business mailing address

722 ELEANOR ST APT 1
KALAMAZOO MI
49007-3302
US

V. Phone/Fax

Practice location:
  • Phone: 269-382-9820
  • Fax: 269-382-8468
Mailing address:
  • Phone: 574-344-9673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number4704354969
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: