Provider Demographics
NPI:1235315532
Name:CAMP, WENDY DIANE (RN,FA)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:DIANE
Last Name:CAMP
Suffix:
Gender:F
Credentials:RN,FA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SAGE WAY
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3519
Mailing Address - Country:US
Mailing Address - Phone:707-224-2953
Mailing Address - Fax:
Practice Address - Street 1:1000 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2906
Practice Address - Country:US
Practice Address - Phone:707-252-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA217742163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant