Provider Demographics
NPI:1275888695
Name:GIPSON, CAMILLE MARGARET (ARNP)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:MARGARET
Last Name:GIPSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:MARGARET
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:800 WEST 5TH STREET
Mailing Address - Street 2:P.O. BOX 148
Mailing Address - City:SUMNER
Mailing Address - State:IA
Mailing Address - Zip Code:50674-1203
Mailing Address - Country:US
Mailing Address - Phone:319-961-8848
Mailing Address - Fax:563-578-5437
Practice Address - Street 1:800 W 5TH ST
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:IA
Practice Address - Zip Code:50674-1214
Practice Address - Country:US
Practice Address - Phone:319-961-8848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA122114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily