Healthcare Provider Details

I. General information

NPI: 1205960028
Provider Name (Legal Business Name): ELIZABETH A CAMP N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 MAIN ST FIRST FLOOR
KEENE NH
03431-4181
US

IV. Provider business mailing address

2321 LINDENWOOD LN
NORMAN OK
73071-7410
US

V. Phone/Fax

Practice location:
  • Phone: 603-391-9820
  • Fax: 866-953-1710
Mailing address:
  • Phone: 603-391-9820
  • Fax: 866-953-1710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number15005
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number56
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: