Basic Information
Provider Information
NPI: 1245305465
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMPER
FirstName: YOLANDA
MiddleName: SWILLIE
NamePrefix: MRS.
NameSuffix:  
Credential: APRN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 130 DESIARD ST
Address2: SUITE 355
City: MONROE
State: LA
PostalCode: 712017319
CountryCode: US
TelephoneNumber: 3188077875
FaxNumber: 3188126603
Practice Location
Address1: 1140 UNIVERSITY AVE
Address2:  
City: MONROE
State: LA
PostalCode: 712090001
CountryCode: US
TelephoneNumber: 3183421651
FaxNumber: 3183423280
Other Information
ProviderEnumerationDate: 11/22/2006
LastUpdateDate: 06/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP04289LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
159165305LA MEDICAID


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