Provider Demographics
NPI:1801023783
Name:CAMP, LAURA MICHELE (MSN, NP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MICHELE
Last Name:CAMP
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:MICHELE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:859 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-3205
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:859 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3205
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO990247363LA2200X, 363LP2300X
CA660740363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48222844Medicaid
CO022892OtherKAISER COMMERCIAL NUMBER
CO022892OtherKAISER COMMERCIAL NUMBER