Provider Demographics
NPI:1821549296
Name:CAMP, RHONDA MAE (RN)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:MAE
Last Name:CAMP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:MAE
Other - Last Name:FARNBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2491 POWERS RD
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NY
Mailing Address - Zip Code:14433-9734
Mailing Address - Country:US
Mailing Address - Phone:315-759-4185
Mailing Address - Fax:
Practice Address - Street 1:2491 POWERS RD
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NY
Practice Address - Zip Code:14433-9734
Practice Address - Country:US
Practice Address - Phone:315-759-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22657449163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse