Provider Demographics
NPI:1235301946
Name:LEDFORD, CAMILLE YORK (NP)
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:YORK
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-3408
Mailing Address - Country:US
Mailing Address - Phone:706-896-5858
Mailing Address - Fax:706-896-5959
Practice Address - Street 1:103 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-3223
Practice Address - Country:US
Practice Address - Phone:706-896-5858
Practice Address - Fax:706-896-5959
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN154445363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA367166824IMedicaid