Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R190071 | MD |
NPI | 1003272840 |
---|---|
Provider Name | Karen Renee Vancamp |
First Address | Towson, MD 21204-0614 |
Second Address | Towson, MD 21204-0614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2016 |
Last Update Date | 22/02/2016 |