Basic Information
| Provider Information | |||||||||
| NPI: | 1891018792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMP | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19550 E 39TH ST S | ||||||||
| Address2: | STE. 210 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640572303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164789071 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19550 E 39TH ST S | ||||||||
| Address2: | STE. 210 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640572303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164789071 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2010 | ||||||||
| LastUpdateDate: | 07/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 2009034582 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | P00949765 | 01 | MO | RAILROAD MEDICARE | OTHER |