Healthcare Provider Details

I. General information

NPI: 1861319360
Provider Name (Legal Business Name): CAMILLE CHALK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 FAWN FESCUE CT
MINDEN NV
89423-8884
US

IV. Provider business mailing address

2635 FAWN FESCUE CT
MINDEN NV
89423-8884
US

V. Phone/Fax

Practice location:
  • Phone: 775-722-4942
  • Fax:
Mailing address:
  • Phone: 775-722-4942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN98013
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: