Provider Demographics
NPI:1184375289
Name:DAVIS, CAMILLE ANTOINETTE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ANTOINETTE
Last Name:DAVIS
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7548 PRESTON RD
Mailing Address - Street 2:STE 141 #1245
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:251-274-8640
Mailing Address - Fax:214-427-6598
Practice Address - Street 1:7548 PRESTON RD
Practice Address - Street 2:STE 141 #1245
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:251-274-8640
Practice Address - Fax:214-427-6598
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059336363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health