Provider Demographics
NPI:1669897468
Name:CAMARGO, JACKIE LAIWAH (FNP-C)
Entity type:Individual
Prefix:
First Name:JACKIE
Middle Name:LAIWAH
Last Name:CAMARGO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 E SEVEN GENERATIONS WAY STE 201-16
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5828
Mailing Address - Country:US
Mailing Address - Phone:520-358-2025
Mailing Address - Fax:
Practice Address - Street 1:10501 E SEVEN GENERATIONS WAY STE 201-16
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-5828
Practice Address - Country:US
Practice Address - Phone:520-358-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5480363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care