MEDICARE: AMBER LEE CAMACHO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1083506463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LEE CAMACHO

Provider Business Mailing Address
First Line	:	1300 N 17TH AVE # 80631
Second Line	:
City	:	GREELEY
State	:	CO
Zip	:	80631-9584
Country	:	US
Telephone Number	:	970-347-2120
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 PACIFIC PL
Second Line	:
City	:	FT LUPTON
State	:	CO
Zip	:	80621
Country	:	US
Telephone Number	:	970-302-2658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2025
Last Update Date	:	07/18/2025

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Directions to “ AMBER LEE CAMACHO ” Practice Location

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