Individual
JACKIE R CAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
213 NW 10TH ST, FAIRFIELD, IL 62837-1216
(618) 842-4617
(618) 380-4565
Mailing address
213 NW 10TH ST, FAIRFIELD, IL 62837-1216
(618) 842-4617
(618) 380-4565
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28156286A
IN
Other
Enumeration date
12/15/2020
Last updated
04/07/2025
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