Camille Krashawn Eubanks

Primary specialty

DriverTaxonomy code 172A00000X

License

D664012517316 Issued in MN

Practice address

6444 84Thcourt
Brooklyn Park, MN 55445

Phone

(763) 370-3806

NPI assigned

Jul 19, 2019

Last updated

Jul 19, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1548813447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 84THCOURT",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55445",
            "telephone_number": "763-370-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6444 84THCOURT",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55445",
            "telephone_number": "763-370-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "CAMILLE",
        "middle_name": "KRASHAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MN",
            "license": "D664012517316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Driver in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Driver in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.