Provider Demographics
NPI:1093799223
Name:PHARAMOND, CAMILLA ELIZABETH (CNM RN)
Entity Type:Individual
Prefix:
First Name:CAMILLA
Middle Name:ELIZABETH
Last Name:PHARAMOND
Suffix:
Gender:F
Credentials:CNM RN
Other - Prefix:
Other - First Name:CAMILLA
Other - Middle Name:ELIZABETH
Other - Last Name:SLAWEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1098 W BALTIMORE PIKE STE 3106
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1098 W BALTIMORE PIKE STE 3106
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-891-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN520777L163W00000X
PAMW008611L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
1324617OtherHIGHMARK BLUE SHIELD
2017306000OtherINDEPENDENCE BLUE CROSS
2120472OtherMAMSI
PA001887412Medicaid
7732340OtherAETNA PPO
30002954OtherKEYSTONE MERCY
2722469OtherAETNA HMO
420001611OtherRR MEDICARE
3Y2715OtherHEALTH NET
2017306000OtherINDEPENDENCE BLUE CROSS
PA054893Medicare PIN