Healthcare Provider Details

I. General information

NPI: 1275496564
Provider Name (Legal Business Name): COLLEEN CAMERON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 RAILROAD ST
SUMMERHILL PA
15958-3312
US

IV. Provider business mailing address

1506 RAILROAD ST
SUMMERHILL PA
15958-3312
US

V. Phone/Fax

Practice location:
  • Phone: 814-495-4484
  • Fax: 814-495-5579
Mailing address:
  • Phone: 814-495-4484
  • Fax: 814-495-5579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN092955L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: