Provider Demographics
NPI:1043681919
Name:CAMILLERI, VICTORIA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:CAMILLERI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 PEACH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2771
Mailing Address - Country:US
Mailing Address - Phone:814-877-5570
Mailing Address - Fax:814-877-5571
Practice Address - Street 1:3330 PEACH ST STE 106
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2771
Practice Address - Country:US
Practice Address - Phone:814-877-5570
Practice Address - Fax:814-877-5571
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily