MEDICARE: SKY NICOLE CAMERON APRN, FNP-C, CANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	222893	OK

General Provider Information

NPI Number	:	1346055209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SKY NICOLE CAMERON APRN, FNP-C, CANS

Provider Business Mailing Address
First Line	:	1123 MAIN ST
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-3121
Country	:	US
Telephone Number	:	405-203-7307
Fax Number	:

Provider Business Practice Location Address
First Line	:	1123 MAIN ST
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-3121
Country	:	US
Telephone Number	:	405-203-7307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	05/22/2025

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