Provider Demographics
NPI:1225287055
Name:CAMDEN, ERIN E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:E
Last Name:CAMDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:GORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4015 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3903
Mailing Address - Country:US
Mailing Address - Phone:804-301-1334
Mailing Address - Fax:
Practice Address - Street 1:4301 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3305
Practice Address - Country:US
Practice Address - Phone:804-358-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002093363A00000X
NJ25MP00190100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0110002093OtherSTATE LICENSE