Provider Demographics
NPI:1932357662
Name:GLIDDEN, CAMILLE RICE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:RICE
Last Name:GLIDDEN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:CAMILLE
Other - Middle Name:BOUDREAUX
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3411 GRAYSTONE PL SE
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8200
Mailing Address - Country:US
Mailing Address - Phone:828-328-1118
Mailing Address - Fax:828-328-1119
Practice Address - Street 1:3411 GRAYSTONE PLACE SE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8200
Practice Address - Country:US
Practice Address - Phone:828-328-1118
Practice Address - Fax:828-328-1119
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006567363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics