Provider Demographics
NPI:1013285873
Name:CAMA, LAURA (PAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CAMA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:NANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:520 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-1662
Mailing Address - Country:US
Mailing Address - Phone:570-265-7000
Mailing Address - Fax:570-268-2111
Practice Address - Street 1:520 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-1662
Practice Address - Country:US
Practice Address - Phone:570-265-7000
Practice Address - Fax:570-268-2111
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000451L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant