Provider Demographics
NPI:1376321810
Name:CUNNINGHAM, CAMILLE Y (APRN)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:Y
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:V
Other - Last Name:YUASENSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3017 CELTIC ASH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-1631
Mailing Address - Country:US
Mailing Address - Phone:702-403-2213
Mailing Address - Fax:
Practice Address - Street 1:4360 BLUE DIAMOND RD STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7785
Practice Address - Country:US
Practice Address - Phone:702-407-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care