Provider Demographics
NPI:1134741226
Name:MORGAN, CAMILLE (RN, BSN)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 AVENUE MONTRESOR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2203
Mailing Address - Country:US
Mailing Address - Phone:347-804-2226
Mailing Address - Fax:
Practice Address - Street 1:3543 AVENUE MONTRESOR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2203
Practice Address - Country:US
Practice Address - Phone:347-804-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336796164W00000X
FL3551858163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No164W00000XNursing Service ProvidersLicensed Practical Nurse