Provider Demographics
NPI:1164773792
Name:FRANK, CAMILLE J (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:J
Last Name:FRANK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5044 HAVERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-3502
Mailing Address - Country:US
Mailing Address - Phone:937-256-2224
Mailing Address - Fax:
Practice Address - Street 1:5044 HAVERFIELD RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-3502
Practice Address - Country:US
Practice Address - Phone:937-256-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-22
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 126079164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse