Provider Demographics
NPI:1316623739
Name:CAMEL, LAURYN
Entity type:Individual
Prefix:
First Name:LAURYN
Middle Name:
Last Name:CAMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19772 PASNOW AVE UPPR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1477
Mailing Address - Country:US
Mailing Address - Phone:216-423-7459
Mailing Address - Fax:
Practice Address - Street 1:19772 PASNOW AVE UPPR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1477
Practice Address - Country:US
Practice Address - Phone:216-423-7459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health