Provider Demographics
NPI:1538641618
Name:CAMACHO, ZENAIDA SILVESTRE (LPN)
Entity Type:Individual
Prefix:
First Name:ZENAIDA
Middle Name:SILVESTRE
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5723
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-5556
Mailing Address - Country:US
Mailing Address - Phone:670-256-5242
Mailing Address - Fax:670-256-5249
Practice Address - Street 1:LEMMAI WAY, KAGMAN II
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-256-5242
Practice Address - Fax:670-256-5249
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP88-548164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse