Provider Demographics
NPI:1033780598
Name:ENGELHART, CAMILLE ELAINE (LPN)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ELAINE
Last Name:ENGELHART
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:ELAINE
Other - Last Name:SENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:725 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2421
Mailing Address - Country:US
Mailing Address - Phone:330-671-6288
Mailing Address - Fax:
Practice Address - Street 1:725 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2421
Practice Address - Country:US
Practice Address - Phone:330-434-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.132488.MEDS-IV164W00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No172V00000XOther Service ProvidersCommunity Health Worker