Gonzales, Camille M

Gonzales, Camille M is an individual health care provider with primary practice located at 454 St Michaels Dr Ste 200 , Santa Fe NM 87505-7602. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gonzales, Camille M can be contacted via phone (505) 303-5000.

Contact Information

Primary practice address
454 St Michaels Dr Ste 200 Santa Fe NM 87505-7602
Phone: (505) 303-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R38444 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP00843 New Mexico

Profile Details

NPI number 1093703985
LBN Legal business name Gonzales, Camille M
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Apr 13th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093703985 NPPES
New Mexico MEDICAID 54704316

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