Provider Demographics
NPI:1942913835
Name:CAMACHO JONES, SHARONDA (RN)
Entity Type:Individual
Prefix:
First Name:SHARONDA
Middle Name:
Last Name:CAMACHO JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 HIBBARD LN
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-1698
Mailing Address - Country:US
Mailing Address - Phone:719-209-5311
Mailing Address - Fax:
Practice Address - Street 1:2131 HIBBARD LN
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1698
Practice Address - Country:US
Practice Address - Phone:719-209-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171745163WP0200X, 163WP0809X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult