Provider Demographics
NPI:1235520636
Name:VAN CAMP, KARI LYNN (APRN-RX,CPNP-PC,FNP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:VAN CAMP
Suffix:
Gender:F
Credentials:APRN-RX,CPNP-PC,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 WAINEE ST
Mailing Address - Street 2:201
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-1589
Mailing Address - Country:US
Mailing Address - Phone:808-280-4192
Mailing Address - Fax:
Practice Address - Street 1:80 PORT STREET EAST
Practice Address - Street 2:408
Practice Address - City:MISSISSAUGA
Practice Address - State:ONTARIO
Practice Address - Zip Code:L5G4V6
Practice Address - Country:CA
Practice Address - Phone:416-476-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI670363LP0200X, 364SC1501X, 363LF0000X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMV2479549OtherDEA