Provider Demographics
NPI:1942777826
Name:TICE-HAROUFF, CAMI JO (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:CAMI
Middle Name:JO
Last Name:TICE-HAROUFF
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RAMBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-3351
Mailing Address - Country:US
Mailing Address - Phone:502-550-6462
Mailing Address - Fax:
Practice Address - Street 1:16 RAMBLEWOOD DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-3351
Practice Address - Country:US
Practice Address - Phone:502-550-6462
Practice Address - Fax:903-205-9198
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1101692363LF0000X
NV852204363LF0000X
RIAPRN03202363LF0000X
CA95015162363LF0000X
DELG-0011994363LF0000X
KY3012827363LF0000X
KS53-81908-041363LF0000X
WAAP61372660363LF0000X
TXAP139517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily