Provider Demographics
NPI:1033375837
Name:CAMPBELL, ANNE CATHERINE (RN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:CATHERINE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:CATHERINE
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP-BC
Mailing Address - Street 1:127 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1297
Mailing Address - Country:US
Mailing Address - Phone:518-773-7931
Mailing Address - Fax:518-736-3933
Practice Address - Street 1:LEXINGTON CENTER
Practice Address - Street 2:127 EAST STATE STREET
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-773-7931
Practice Address - Fax:518-736-3933
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338518363LF0000X
NYF338518-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03818499Medicaid