Provider Demographics
NPI:1396326567
Name:CAMARENA, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:CAMARENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WANDA ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OK
Mailing Address - Zip Code:73448-1200
Mailing Address - Country:US
Mailing Address - Phone:580-276-2400
Mailing Address - Fax:
Practice Address - Street 1:300 WANDA ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OK
Practice Address - Zip Code:73448-1200
Practice Address - Country:US
Practice Address - Phone:580-276-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK40284207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine