Provider Demographics
NPI:1699332882
Name:CAMERON, ANDREA CHARMAYNE (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CHARMAYNE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MERCADO ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7308
Mailing Address - Country:US
Mailing Address - Phone:303-324-1452
Mailing Address - Fax:719-595-7045
Practice Address - Street 1:1 MERCADO ST STE 200
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7308
Practice Address - Country:US
Practice Address - Phone:970-382-9500
Practice Address - Fax:719-595-7045
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007525363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant