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NPI Code Detail

MEDICARE: CAMELLA DAWN LADD FNP-C

MEDICARE:   CAMELLA DAWN LADD  FNP-C
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
1363LF0000XFamily Nurse PractitionerAP144298TX

General Provider Information

NPI Number : 1952931693
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMELLA DAWN LADD FNP-C
Provider Business Mailing Address
First Line : PO BOX 840026
Second Line :
City : DALLAS
State : TX
Zip : 75284-0026
Country : US
Telephone Number : 806-212-6353
Fax Number : 806-212-0559
Provider Business Practice Location Address
First Line : 3501 S SONCY RD STE 150
Second Line :
City : AMARILLO
State : TX
Zip : 79119-6426
Country : US
Telephone Number : 806-212-6353
Fax Number : 806-212-0559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2020
Last Update Date : 09/21/2022

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Directions to “ CAMELLA DAWN LADD FNP-C” Practice Location

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