Provider Demographics
NPI:1043564297
Name:ANDERSON, CAMARELL D
Entity Type:Individual
Prefix:MRS
First Name:CAMARELL
Middle Name:D
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 TWIN DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-3230
Mailing Address - Country:US
Mailing Address - Phone:580-656-0492
Mailing Address - Fax:
Practice Address - Street 1:2202 TWIN DR
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-3230
Practice Address - Country:US
Practice Address - Phone:580-656-0492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay