Provider Demographics
NPI:1952689606
Name:CAMARA, JASON (LPN)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:CAMARA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 QUARRY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1025
Mailing Address - Country:US
Mailing Address - Phone:508-679-8111
Mailing Address - Fax:508-674-4286
Practice Address - Street 1:387 QUARRY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1025
Practice Address - Country:US
Practice Address - Phone:508-679-8111
Practice Address - Fax:508-674-4286
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN85921164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse