Provider Demographics
NPI:1053677203
Name:CAMARENA, NOELLE BETH (RN)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:BETH
Last Name:CAMARENA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 BUSINESS PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7174
Mailing Address - Country:US
Mailing Address - Phone:907-743-7386
Mailing Address - Fax:907-743-7241
Practice Address - Street 1:4951 BUSINESS PARK BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-743-7200
Practice Address - Fax:907-743-7241
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA764393163W00000X
CA95007706363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse