Basic Information
Provider Information
NPI: 1649612193
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMERON
FirstName: APRIL
MiddleName: CAMILLE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 75 PIEDMONT AVE NE
Address2: STE 700
City: ATLANTA
State: GA
PostalCode: 303032544
CountryCode: US
TelephoneNumber: 4047561403
FaxNumber: 4047561402
Practice Location
Address1: 1800 HOWELL MILL RD NW
Address2: STE 275
City: ATLANTA
State: GA
PostalCode: 303182538
CountryCode: US
TelephoneNumber: 4047561400
FaxNumber: 4047561402
Other Information
ProviderEnumerationDate: 07/25/2013
LastUpdateDate: 08/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN218393GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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