Provider Demographics
NPI:1902364730
Name:GONZALEZ CAMEJO, JANOI (RN, NSN, NP-C)
Entity Type:Individual
Prefix:
First Name:JANOI
Middle Name:
Last Name:GONZALEZ CAMEJO
Suffix:
Gender:M
Credentials:RN, NSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-6101
Mailing Address - Country:US
Mailing Address - Phone:602-283-5732
Mailing Address - Fax:
Practice Address - Street 1:6502 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-1496
Practice Address - Country:US
Practice Address - Phone:602-283-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily