Healthcare Provider Details

I. General information

NPI: 1093799223
Provider Name (Legal Business Name): CAMILLA ELIZABETH PHARAMOND CNM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAMILLA ELIZABETH SLAWEK

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1098 W BALTIMORE PIKE STE 3106
MEDIA PA
19063-5139
US

IV. Provider business mailing address

1098 W BALTIMORE PIKE STE 3106
MEDIA PA
19063-5139
US

V. Phone/Fax

Practice location:
  • Phone: 610-891-6240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN520777L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW008611L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: