Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN11016399 | FL |
NPI | 1023773850 |
---|---|
Provider Name | Kala Marie Camper |
First Address | Brandon, FL 33511-6502 |
Second Address | Tampa, FL 33612-3413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2021 |
Last Update Date | 28/11/2021 |