Healthcare Provider Details

I. General information

NPI: 1437345725
Provider Name (Legal Business Name): CONSTANCE ELLEN CAMERON MSN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 FRANKLIN AVE
TOLEDO OH
43620-1402
US

IV. Provider business mailing address

2200 JEFFERSON AVE 4TH FLOOR
TOLEDO OH
43604-7101
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-2453
  • Fax: 419-251-2314
Mailing address:
  • Phone: 419-251-8983
  • Fax: 419-251-6719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN 211831
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: