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General NPI Number Information
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NPI Number | 1023985785
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Entity Type | Individual
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Provider Name | CAMRIA RENEE DEATON BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2025
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 200 JEFFERSON AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4502
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Country | US
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Telephone | 616-685-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 5384 MCCORMICK DR SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-8770
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Country | US
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Telephone | 616-826-2106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704415640
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License Number State | MI
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