Provider Demographics
NPI:1831764885
Name:LACAMBACAL, DANIEL VINCENT SERAME (DNP)
Entity type:Individual
Prefix:
First Name:DANIEL VINCENT
Middle Name:SERAME
Last Name:LACAMBACAL
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:DAVE
Other - Middle Name:
Other - Last Name:LACAMBACAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5102 N ROXBORO ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1420
Mailing Address - Country:US
Mailing Address - Phone:919-680-1045
Mailing Address - Fax:919-471-1298
Practice Address - Street 1:5102 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1420
Practice Address - Country:US
Practice Address - Phone:919-680-1045
Practice Address - Fax:919-471-1298
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily