Provider Demographics
NPI:1730999483
Name:CAMREN, LILLY DANAE
Entity type:Individual
Prefix:
First Name:LILLY
Middle Name:DANAE
Last Name:CAMREN
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 1:705 S VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-4439
Mailing Address - Country:US
Mailing Address - Phone:981-337-8080
Mailing Address - Fax:918-337-8099
Practice Address - Street 1:705 S VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-4439
Practice Address - Country:US
Practice Address - Phone:981-337-8080
Practice Address - Fax:918-337-8099
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist