Provider Demographics
NPI:1245797067
Name:MOREL, CAMMIE ELIZABETH
Entity Type:Individual
Prefix:
First Name:CAMMIE
Middle Name:ELIZABETH
Last Name:MOREL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 BRADFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4005
Mailing Address - Country:US
Mailing Address - Phone:989-402-7663
Mailing Address - Fax:
Practice Address - Street 1:1202 BRADFIELD ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-4005
Practice Address - Country:US
Practice Address - Phone:989-402-7663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703110804164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse