Provider Demographics
NPI:1235663105
Name:CAMERON, FAY MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:FAY
Middle Name:MARIE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W BOUGAINVILLEA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7437
Mailing Address - Country:US
Mailing Address - Phone:813-932-4381
Mailing Address - Fax:
Practice Address - Street 1:116 W BOUGAINVILLEA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7437
Practice Address - Country:US
Practice Address - Phone:813-932-4381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9277238363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health