Provider Demographics
NPI:1083499081
Name:CAMORIANO, BAHAR (RN)
Entity Type:Individual
Prefix:
First Name:BAHAR
Middle Name:
Last Name:CAMORIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BAHAR
Other - Middle Name:
Other - Last Name:KHARATIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 N MARTIN AVE TUCSON AZ 85721
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0001
Mailing Address - Country:US
Mailing Address - Phone:520-626-6154
Mailing Address - Fax:
Practice Address - Street 1:13630 N 12TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4968
Practice Address - Country:US
Practice Address - Phone:520-333-8390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23881286163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse