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General NPI Number Information
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NPI Number | 1407524275
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Entity Type | Individual
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Provider Name | CAMILLE CROMWELL FNP
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Gender | Female
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Dates
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Enumeration Date | 09/05/2021
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 850 PROSPECT ST STE 1
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City | LA JOLLA
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State | CA
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Zip | 92037-4208
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Country | US
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Telephone | 775-722-7317
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Fax | 762-889-0420
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Provider Business Mailing Address
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Address Line | 1140 WALL ST UNIT 543
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City | LA JOLLA
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State | CA
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Zip | 92038-7023
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Country | US
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Telephone | 858-255-0416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 95018292
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License Number State | CA
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