Provider Demographics
NPI:1851328868
Name:KAMERER, ELIZABETH A (CNM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:KAMERER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1146
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25402-1146
Mailing Address - Country:US
Mailing Address - Phone:304-263-4999
Mailing Address - Fax:
Practice Address - Street 1:99 TAVERN RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2890
Practice Address - Country:US
Practice Address - Phone:304-263-4999
Practice Address - Fax:304-263-0984
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127579367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405488100Medicaid
MDLT35 / 531165-03OtherBC / BS OF MD
MDS186 / S186OtherBLUECHOICE
MD405488100Medicaid