Provider Demographics
NPI:1043752793
Name:HADDIX, CAMILLIA (DNP)
Entity Type:Individual
Prefix:DR
First Name:CAMILLIA
Middle Name:
Last Name:HADDIX
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GERMANTOWN CT STE 402
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4275
Mailing Address - Country:US
Mailing Address - Phone:901-752-4900
Mailing Address - Fax:901-752-4902
Practice Address - Street 1:65 GERMANTOWN CT STE 402
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4275
Practice Address - Country:US
Practice Address - Phone:901-752-4900
Practice Address - Fax:901-752-4902
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21802363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily