Provider Demographics
NPI:1083699581
Name:BOATWRIGHT, CAMISHA QUINISE (RN)
Entity Type:Individual
Prefix:MS
First Name:CAMISHA
Middle Name:QUINISE
Last Name:BOATWRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HHC 121 GENERAL HOSPITAL
Mailing Address - Street 2:BOX #42
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205
Mailing Address - Country:KR
Mailing Address - Phone:737-5575
Mailing Address - Fax:
Practice Address - Street 1:HHC 121 GENERAL HOSPITAL
Practice Address - Street 2:BOX #42
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:KR
Practice Address - Phone:737-5575
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001189731163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical