Provider Demographics
NPI:1194994889
Name:PRIESMEYER, CAMERON L (ARNP-C)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:L
Last Name:PRIESMEYER
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 7TH AVE N
Mailing Address - Street 2:STE 107
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1348
Mailing Address - Country:US
Mailing Address - Phone:727-894-1661
Mailing Address - Fax:727-894-1430
Practice Address - Street 1:1111 7TH AVE N
Practice Address - Street 2:STE 107
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1348
Practice Address - Country:US
Practice Address - Phone:727-894-1661
Practice Address - Fax:727-894-1430
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1346292363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS70263Medicare UPIN