Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | A004780 | AR |
N | 363LG0600X | Nurse Practitioner - Gerontology | A004780 | AR |
NPI | 1013367226 |
---|---|
Provider Name | Rebecca A Camp |
First Address | Conway, AR 72032-9733 |
Second Address | Little Rock, AR 72223-4217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2016 |
Last Update Date | 18/06/2016 |