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Individual

LUIS FELIPE CAMACHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
305 W 15TH ST STE 102, LIBERAL, KS 67901-2455
(620) 417-7578
(680) 417-7577
Mailing address
315 W 15TH ST, LIBERAL, KS 67901-2455
(620) 624-1651
(620) 629-6523

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
82969
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82969
KANSAS STATE LICENSE
KS
Enumeration date
02/08/2021
Last updated
10/02/2024
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