Provider Demographics
NPI:1174881478
Name:PRICE, CAMMIE GAIL (APRN)
Entity type:Individual
Prefix:MRS
First Name:CAMMIE
Middle Name:GAIL
Last Name:PRICE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 E HARDING ST
Mailing Address - Street 2:
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110-4507
Mailing Address - Country:US
Mailing Address - Phone:501-354-4637
Mailing Address - Fax:
Practice Address - Street 1:1711 E HARDING ST
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-4507
Practice Address - Country:US
Practice Address - Phone:501-354-4637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily