Provider Demographics
NPI:1326541574
Name:CAMERON-MATTHEWS, CAROL ELIZABETH (DNP, PMHNP-BC, NP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ELIZABETH
Last Name:CAMERON-MATTHEWS
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 EXECUTIVE CENTER DR STE 235
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8821
Mailing Address - Country:US
Mailing Address - Phone:704-936-0200
Mailing Address - Fax:704-963-0226
Practice Address - Street 1:5500 EXECUTIVE CENTER DR STE 235
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8821
Practice Address - Country:US
Practice Address - Phone:704-493-8619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC249535363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1174559504OtherHEALTH SERVICES
NC1902411499Medicaid