Provider Demographics
NPI:1558763060
Name:CAMACHO, DEANNA MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MARIE
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:MARIE
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22710 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6008
Mailing Address - Country:US
Mailing Address - Phone:281-726-3506
Mailing Address - Fax:281-719-5907
Practice Address - Street 1:22710 PROFESSIONAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6008
Practice Address - Country:US
Practice Address - Phone:281-312-8530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily