Marcie Marie Camblin, MSN, ACNPC-AG, CCRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP10481 Issued in AZ

Practice address

16551 N Naegel Dr
Surprise, AZ 85374-5411

Phone

(623) 764-7402

NPI assigned

Aug 8, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1508381880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16551 N NAEGEL DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745411",
            "telephone_number": "623-764-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16551 N NAEGEL DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745411",
            "telephone_number": "623-764-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMBLIN",
        "first_name": "MARCIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, ACNPC-AG, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP10481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD",
            "identifier": "AP10481",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ASSOCIATION OF CRITICAL CARE NURSING",
            "identifier": "2000025194",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Anne Caldwell, APRN-CNM
• Dan W Caldwell II, HAD
• Roger Caldwell
• Steven Richard Call, D.D.S.
• Angelica Camacho
• Andrea Lauren-Nicole Campbell, PHARM D
• Bobbi-Jo Campbell, FNP-C
• Jill Marie Campbell, COTA/L
• Kylie E Campbell
• Shea KL Campbell, PT, DPT

• Gerontology Nurse Practitioner in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Gerontology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.