Camille Christine Gorden, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP9279833 Issued in FL

Practice address

13770 Beach Blvd
Suite # 6
Jacksonville, FL 32224-7205

Phone

(904) 242-4220

Fax

(904) 242-4221

NPI assigned

Jul 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Camille Christine Hanson Former name

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": "1215820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1598929192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 BEACH BLVD",
            "address_2": "SUITE # 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247205",
            "telephone_number": "904-242-4220",
            "fax_number": "904-242-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13770 BEACH BLVD",
            "address_2": "SUITE # 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247205",
            "telephone_number": "904-242-4220",
            "fax_number": "904-242-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDEN",
        "first_name": "CAMILLE",
        "middle_name": "CHRISTINE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-12",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9279833",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9279833",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003867800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "HANSON",
            "middle_name": "CHRISTINE",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Arun Gopinath, M.D
• Dheeraj Reddy Gopireddy, M.D, M.P.H
• Edward J. Gorak II, D.O.
• Sarah Nichole Gorall, PA
• Venkatesan R Gorantla, M.D.
• Aisha Gordon, LCSW
• Brandon Troy Gordon, MD
• Candace Michele Gordon, APRN
• Jonathan Dales Gordon, D.M.D.
• Kesha M. Gordon, CPT, BLSI

• Pediatric Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.