Provider Demographics
NPI:1396192340
Name:CAMERON, KATIE ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ELIZABETH
Last Name:CAMERON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2699 SANDLIN RD SW STE B8
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-7343
Mailing Address - Country:US
Mailing Address - Phone:256-822-2171
Mailing Address - Fax:256-822-2169
Practice Address - Street 1:2699 SANDLIN RD SW STE B8
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-7343
Practice Address - Country:US
Practice Address - Phone:256-822-2171
Practice Address - Fax:256-822-2169
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-122763363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner