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General NPI Number Information
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NPI Number | 1518590553
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Entity Type | Individual
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Provider Name | CAMEO ELIZABETH JOHNSON PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 2030 W BASELINE RD # 182-8355
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City | PHOENIX
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State | AZ
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Zip | 85041-6574
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Country | US
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Telephone | 928-235-2927
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Fax | 928-268-0289
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Provider Business Mailing Address
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Address Line | 60 E QUARTZ RD
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City | FLAGSTAFF
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State | AZ
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Zip | 86005-7093
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Country | US
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Telephone | 928-243-0244
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 238464
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License Number State | AZ
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