Provider Demographics
NPI:1912892597
Name:RICHBURG, CAMILLA LENDREA
Entity type:Individual
Prefix:
First Name:CAMILLA
Middle Name:LENDREA
Last Name:RICHBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 KENNEDY ST NW APT 501
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6526
Mailing Address - Country:US
Mailing Address - Phone:202-212-9143
Mailing Address - Fax:
Practice Address - Street 1:429 KENNEDY ST NW APT 501
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6526
Practice Address - Country:US
Practice Address - Phone:202-212-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide