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General NPI Number Information
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NPI Number | 1346556909
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Entity Type | Organization
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Legal Business Name | C L CAMBELL LLC
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 728 W 100 S STE 1
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City | HEBER CITY
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State | UT
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Zip | 84032-3764
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Country | US
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Telephone | 435-654-4192
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Fax | 435-654-4067
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Provider Business Mailing Address
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Address Line | 728 W 100 S STE 1
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City | HEBER CITY
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State | UT
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Zip | 84032-3764
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Country | US
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Telephone | 435-654-4192
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Fax | 435-654-4067
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LARA LAPERLE
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Credential |
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Telephone | 435-654-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 852049924405
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License Number State | UT
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