Provider Demographics
NPI:1639226988
Name:MADDEN, CAMILLE MARY (NP)
Entity Type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:MARY
Last Name:MADDEN
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Gender:F
Credentials:NP
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Mailing Address - Street 1:15 PARKMAN ST
Mailing Address - Street 2:SUITE 625
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3117
Mailing Address - Country:US
Mailing Address - Phone:617-726-7939
Mailing Address - Fax:617-724-2814
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:SUITE 625
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-7939
Practice Address - Fax:617-724-2814
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA127135363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health