Provider Demographics
NPI:1699480889
Name:NORWICK, CAMILLE ADAIR (APRN, PMHNP)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ADAIR
Last Name:NORWICK
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 MONTEZUMA AVE # 128
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2835
Mailing Address - Country:US
Mailing Address - Phone:505-470-3838
Mailing Address - Fax:
Practice Address - Street 1:1600 LENA ST STE C2
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4338
Practice Address - Country:US
Practice Address - Phone:505-470-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM715862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry