Provider Demographics
NPI:1851006068
Name:CAMACHO YAU, KATELYN NELYSE (BSN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:NELYSE
Last Name:CAMACHO YAU
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 HOLLAND CIR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-3974
Mailing Address - Country:US
Mailing Address - Phone:662-603-4656
Mailing Address - Fax:
Practice Address - Street 1:110 HOLLAND CIR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-3974
Practice Address - Country:US
Practice Address - Phone:662-603-4656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-155148163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care