Provider Demographics
NPI:1982368262
Name:PRICE, KAMERON BERRY
Entity Type:Individual
Prefix:MRS
First Name:KAMERON
Middle Name:BERRY
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KAMERON
Other - Middle Name:MCKENZIE
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:125 PRESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7654
Mailing Address - Country:US
Mailing Address - Phone:864-980-5994
Mailing Address - Fax:
Practice Address - Street 1:865 OLD CLEMSON HWY STE A
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-8060
Practice Address - Country:US
Practice Address - Phone:864-520-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-23
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235574163W00000X
SC26460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse