Provider Demographics
NPI:1033203120
Name:HENDSBEE, CAMILLE ELIZABETH (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:ELIZABETH
Last Name:HENDSBEE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W CENTRAL ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4537
Mailing Address - Country:US
Mailing Address - Phone:508-315-3042
Mailing Address - Fax:508-315-3042
Practice Address - Street 1:86 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4335
Practice Address - Country:US
Practice Address - Phone:508-651-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA782133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11572392OtherCAQH
MA449134HENOtherUNITED HEALTH
MALD0163OtherBLUE CROSS BLUE SHIELD
MD9413892OtherPHCS
MAAA-35766OtherHARVARD PILGRIM
MA2409167OtherCIGNA
MAHEMTO718Medicare ID - Type Unspecified