Provider Demographics
NPI:1912606831
Name:CAMDEN, REE AMANDA
Entity Type:Individual
Prefix:
First Name:REE
Middle Name:AMANDA
Last Name:CAMDEN
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:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:OH
Mailing Address - Zip Code:43466-0384
Mailing Address - Country:US
Mailing Address - Phone:419-619-1683
Mailing Address - Fax:
Practice Address - Street 1:381 S WATSON ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:OH
Practice Address - Zip Code:43466-7083
Practice Address - Country:US
Practice Address - Phone:419-619-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant