Provider Demographics
NPI:1720187669
Name:MEYHOFF, CAMILLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MEYHOFF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4436
Mailing Address - Country:US
Mailing Address - Phone:701-323-5202
Mailing Address - Fax:701-323-5369
Practice Address - Street 1:222 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4436
Practice Address - Country:US
Practice Address - Phone:701-323-5202
Practice Address - Fax:701-323-5369
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR27327363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720187669OtherNPI
NDP00259282OtherRAILROAD MEDICARE